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Neuro > neuro10 > Flashcards

neuro10 Flashcards

1
Q

pain sensitiv structures in the brain

A

meninges (pia mater), the CNs, the arteries that make up the circle of Willis and its proximal branches, meningeal vessels, external carotid artery, the scalp, pericranial muscles, mucosa of the paransal sinues, the teeth, and cervical nerve roots

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2
Q

temporal artery tenderness

A

suggests giant cell arteritis

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3
Q

characteristics of migraine headaches

A

unilateral, throbbnf or pulsating; often assoc with n/v; exacerbated by movement, light or sounds

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4
Q

how long do migraines typically last

A

several to 72 hours

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5
Q

classic vs common migraine

A

classic is migraine w aura; common is migraine without aura

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6
Q

scotoma

A

partial alteration in the field of vision

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7
Q

pathophys of migraine

A

starts with cortical spreading depression, a wave of hyperpolarization followed by wave of depol, that spreads acorss a region of the cortex

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8
Q

pain with migraine

A

CSD leads to the release of chemicals that activate trigeminal nerve afferents, that leads to activation of in the trigeminal nucleus caudalis and brainstem parasymp efferent projections

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9
Q

drugs that should be taken early in the course of migraine

A

triptans; should be used w caution in patients with coronary artery disease

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10
Q

abortive therapy in migraines

A

triptans, ergotamine derivatives, caffeine-containing compounds, and IV antiemetics like metoclopramide and prochlorperazine

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11
Q

propylactic treatment for migraines

A

beta blockers, TCAs and anticonvulsants

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12
Q

when is prophylactic therapy used

A

when headaches occur more freq than once per month

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13
Q

characteristics of tension headaches

A

recurrent attacks of bilateral or holocranial headaches of a pressing, squeezing, or tightening sensation

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14
Q

duration of tension headaches

A

30 min to several days

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15
Q

example of a trigeminal autonomic cephalgias

A

cluster headaches

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16
Q

trigeminal autonomic cephalgias

A

unilateral trigeminal nerve distribution pain, accompanied by prominent ipsilateral autonomic symptoms

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17
Q

cluster headache characteristics

A

periods of several days or weeks or months in which headaches occur with a high freq followed by headache free periods of months or years

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18
Q

location of cluster headaches

A

usually unilateral (but can flip to the other side within a cluster); usually over the orbit or temporal region;

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19
Q

cranial autonomic symptoms seen in cluster headaches

A

lacrimation, conjunctival injection, facial or forehead swelling, eyelid edema, nasal congestion, rhinorrhea, and signs of Horner’s (miosis, ptosis)

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20
Q

patients feel the need to get up and move aroudn to relieve the headache

A

cluster headache

21
Q

abortive agents in cluster headaches

A

triptans; steroids may shorten the duration

22
Q

long term prophylaxis for cluster headaches

A

verapamil and lithium

23
Q

another type of trigeminal autonomic cephalgia besides cluster headache

A

paroxysmal hemicrania

24
Q

characteristics of paroxysmal hemicrania

A

unilateral headache with accompanying autonomic symptoms; episdoes are typically much shorter than cluster headaches (10-30min) and occur with greater freq

25
Q

best treatment for paroxysmal hemicrania

A

the NSAID indomethacin

26
Q

worst headache of my life

A

subarachnoid hemorrhage

27
Q

SAH headache characteristic

A

begins suddenly and peaks in intensity within seconds of its onset (thunderclap headache)

28
Q

diagnosis of SAH

A

head CT followed by LP to show presence of blood or blood breakdown products in CSF

29
Q

what is a low pressure HA

A

low pressure within the subarchnoid space or CSF; symptoms are worse in the upright position and alleviated by recombency; typically bilateral;

30
Q

idiopathic intracranial hypertension

A

elevated pressure within the subarachnoid space; increasing severity when recombent; may have pulsatile tinnitus and transient visual obscurations;

31
Q

other characteristics of idiopathic intracranial htn

A

papilledema, unilateral or bilateral sixth nerve palsy;

32
Q

mimic of idiopahtic intracranial hypertension

A

venos sinus thrombosis

33
Q

treatment of idiopathic intracranial hypertension

A

carbonic anhydrase inhib like acetazlamide and topiramate; repeated LPs and diuretics, as well as optic nerve fenestration and occasionally lumboperitoneal shunting

34
Q

most important complicaiton of IIH

A

vsual loss due to a compresive optic neuropathy from persistently elevated CSF pressure;

35
Q

temporal arteritis

A

also known as giant cell arteritis; systemic granulomatous arteritis that affects med and large arteries, typically in people over age 50

36
Q

headache with giant cell arteritis

A

may be assoc with tenderness of the scalp as well as thicening, nodulation, and tenderness of the temporal arteries to palpation; may see claudication of the jaw with chewing and systemic sx

37
Q

most feared complication of temporal arteritis

A

visual loss rom an anterior ischemic neuropathy

38
Q

treatment of temporal arteritis

A

high dose steroids

39
Q

chronic daily headache def

A

headache at least 15 days per month

40
Q

dental causes of facial pain

A

temporomandiular joint disease

41
Q

neurologic causes of facial pain

A

trigeminal neuralgia, glossopharyngeal neuralgia, and postherpetic neuralgia

42
Q

trigeminal neuralgia

A

syndrome characterized by paroxysms of severe neuropathic pain in the distribution of one or more branches of the trigeminal nerve; short paroxysms of electrical like painful sensation in the face

43
Q

pathogenesis of trigeminal neuralgia

A

compression of the trigeminal nerve root at the cerebelopontine angle, most often by an aberrant vascular loop

44
Q

treatment for trigeminal neuralgia

A

carbamazepine

45
Q

trigeminal neuralgia that is refractory to carbamazepine and other anticonvulsants

A

percutaneous radiofreqency ablation and microvascular decompression

46
Q

postherpetic neuralgia

A

neuropathic pain that may accompany and follow an acute attack of varicella zoster (shingles)

47
Q

pain associated with postherpetic neuralgia

A

burning, itching, and hypersensitivity to light touch

48
Q

management of postherpetic neuralgia

A

symptomatic with TCAs and gabapentin

49
Q

how do carbonic anhydrase inhib treat IIH

A

reduce production of CSF

Neuro (43 decks)

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