Neurological Flashcards
What most commonly affects the heart and eyes simultaneously?
Vascular disease
What are possible causes of CNVI nerve palsy?
Microvascular, raised ICP, tumour, congenital
What sign may you see in a CNIV nerve palsy?
Head tilt-due to weak incyclo-torsion
What are possible causes of CNIV nerve palsy?
Congenital decompensated, microvascular, tumour, closed head trauma (bilateral)
What are possible causes of CNIII nerve palsy?
Microvascular, tumour, aneurysm, MS, congenital
What is the likely cause of a painful CNIII palsy?
Aneurysm
What is Inter-nuclear Ophthalmoplegia?
A disorder of conjugate lateral gaze in which the affected eye shows impairment of adduction
Damage to what causes Inter-nuclear Ophthalmoplegia?
Medial longitudinal fasciculus
What are possible causes of Inter-nuclear Ophthalmoplegia?
MS, Vascular, many others
What are possible causes of visual field defects?
Vascular disease (CVA), space occupying lesion (SOL), demyelination (MS), trauma (including surgical)
What causes visual field defects that are due to optic nerve pathology?
Ischaemic optic neuropathy, optic neuritis (commonly MS), tumours (rare)- meningioma, glioma, haemangioma
How does optic neuritis present?
Progressive visual loss, pain behind eye especially on movement, colour desaturation, central scotoma
What can cause visual defects at the optic chiasm?
Pituitary tumour, craniopharyngioma, meningioma
What visual field defect occurs due to pathology at the optic chiasm?
Bi-temporal field defect
What can cause visual defects at the optic tracts and radiations?
Tumours (1’, 2’), demyelination, vascular abnormalities
What are the properties of defects relating to the optic tracts and radiations?
Homonomous defects, not spared macula. Quadrantanopia, incongruous
What can cause visual field defects at the occipital cortex?
Vascular disease (CVA), demyelination
What are the properties of defects relating to the occipital cortex?
Homonomous defect with macula sparing. Congruous
What is papilloedema?
Swollen optic discs secondary to raised ICP
How does papilloedema occur?
When ICP increases, this is transmitted to the SAS then to the optic nerve. Causes interruptiion of axoplasmic flow and venous congestion leading to swollen discs
What is ICP the sum of?
Brain (80%), blood (10%), CSF (10%)
What eventually happens to the brain in raised ICP?
Squeezed through foramen magnum, brainstem compresses, patients stops breathing and dies
Why do discs swell in malignant HT?
Mechanism poorly understood: maybe failure of ONH autoregulation, or HT-related increased ICP
When will ICP increase in CSF pathology?
Obstruction to CSF circulation, overproduction of CSF, inadequate absorption
What can cause obstruction of CSF circulation leading to raised ICP disc swelling?
Possibly: stenosis of transverse cerebral sinuses, or increased abdo pressure (often obese patients)
What can impair CSF absorption leading to raised ICP and disc swelling?
Possibly: role of vitamin A, microemboli in sagittal sinus blocks CSF absorption
What happens if disc swelling becomes chronic?
Swelling subsides, disc becomes atrophic and pale. Loss of visual function occur, blindness may result
