Neurology 1 - Demyelination, Facial Pain And Cerebrovascular Flashcards
Look at m recap
What is a stroke?
What are the 2 types?
What are the stroke common symptoms?
A focal neurological deficit which lasts longer than 24 hours resulting from a vascular lesion.
- Ischaemic
- Haemorrhagic
Face – Asymmetry of the face – Unilateral palsy
Arms – Weakness in the arms
Speech - Slurring of speech - (Dysarthria)
Time – Phone for help
Stroke symptoms?
Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
Palsy is paralysis.
Sudden severe headache with no known cause. (Haemorrhagic)
Confusion, trouble speaking, or difficulty understanding speech.
Aphasia is an impairment of language, affecting the production or comprehension of speech and the ability to read or write.
Sudden trouble seeing in one or both eyes. (Visual Field Defects)
Ataxia - Sudden trouble walking (gait disturbance), dizziness, loss of balance, or lack of coordination.
Ischaemic stroke?
How do you treat it?
Area of the brain deprived of blood
Obstruction blocks the flow to part of the brain
Thrombus (Atheroma, Vegetations – IE) Atheroma / atherosclerotic plaques Severe hypoteinsion
80% of all stroke events
Treatment with thrombolysis in acute phase (Alteplase)
Haemorrhagic stroke?
Area of bleeding
Weakened vessel walls rupturing causing bleeding into the brain
Aneurysm
20% of all stroke events
What is a Transient Ischemic Attack ?
A focal neurological deficit which lasts less than 24 hours resulting from a vascular lesion. The deficit fully resolves
Temporary in nature
Requires active preventative treatment and investigation
Risk factors of a stroke?
Diabetes
Cigarettes
Obesity
Oestrogen OCP
Excess EtOH
Polycythaemia (Raised haemaglobin)
Atheroma (hypercholesterol / lipid aemia)
Hereditable nature
Hypertension
Is left side is damaged what side of body paralysed?
Lesions and outcomes of a stroke
What is the treatment and risk reduction of a stroke?
Nil by mouth = no food, drink or mouth medication (until salt therapy - language and speech assessment)
What can be given to prevent a TIA?
Carotid endarterectomy
Tia = warning shot / mini stroke
What is Subarachnoid Haemorrhage ?
Uncommon type of stroke caused by bleeding into the brain. - Arterial
Classic “Thunderclap headache” with neck stiffness
Circle of Willis Berry Aneurysm rupture
Sudden LOC – shortly after event
Menginism
High pressure so fast onset
MRI
Often Neuro surgery clip & Tie bleeder if not stopped spontaneously
What is extradural haematoma?
Young patient
Involved in a head strike (either during sport or a result of a motor vehicle accident) may or may not lose consciousness transiently.
Following the injury they regain a normal level of consciousness (lucid interval).
Usually have an ongoing and often severe headache.
Over the next few hours they gradually lose consciousness.
Arterial Middle meningeal artery damage CT/MRI - convex blood mass
What is subdural haematoma?
“Below the dura”
Slower onset – venous
Collection between the dura and the brain
Blood collection causes ”mass effect”
Typically after fall (anti- coagulants)
What are the different types of brain haemorrhage?
(4)
1) epidural haematoma
2) subdural haematoma
3) subarachnoid haemorrhage
4) inter-cerebral haemorrhage
What is epilepsy?
What are the types of epilepsy?
Does epilepsy always have seizures?
A neurological disorder marked by sudden recurrent episodes of sensory disturbance, loss of consciousness, or convulsions, associated with abnormal electrical activity in the brain.
Various types of epilepsy – General, Focal (simple partial)
Not all have seizures
Temporary bursts of electrical activity in the brain that affects how the brain works.
When does epilepsy start?
How long does epilepsy last?
How is epilepsy managed?
Can start at any age, but usually in childhood or over 60
Can be secondary to other neurological pathologies – tumors / strokes
Life-long condition
Managed with anti-convulsants
What is a tonic clonic seizure? (Grand mal)
Muscle Contractions
Stiff, Jerking muscular movements
Unable to communicate – blank stare / aphasic
Vomiting or loss of bladder/bowels
Cheek and tongue biting
Breathing difficulties
Loss of consciousness
Recovery – Variable but 5 minute duration not unusual
“Feels like I ran a marathon”
What are simple partial seizures?
Simple partial (focal) seizures or “auras” can cause:
A simple partial seizure a general strange feeling that’s hard to describe
A feeling that events have happened before (déjà vu)
A sinking feeling in your abdomen – like when on a fairground ride
Unusual smells or tastes / tingling in your arms and legs stiffness or twitching in part of your body, such as an arm or hand
You remain awake and aware while this happens.
Considered as “warnings” or “auras” as they can be a herald of another type of seizure
What are complex partial seizures?
During a complex partial seizure, you lose your sense of awareness and make random body movements, such as:
Smacking of lips
Rubbing of hands
Making random noises
Moving arms around
Picking at clothes or fiddling with objects
Chewing or swallowing
Patient won’t be able to respond to anyone during seizure and won’t have any memory of it.
What is Absences (Petit-mal) ?
Absence Seizure
An absence seizure, is where you lose awareness of your surroundings for a short time. Mainly affect children, but can happen at any age.
During an absence seizure, a person may:
Stare blankly into space
Look like they’re “daydreaming”
Flutter their eyes
Make slight jerking movements of their body or limbs
The seizures usually only last up to 15 seconds and you won’t be able to remember them.
They can happen several times a day.
Other types of seizures?
Seizure - triggers
What are the triggers for a seizure?
Stress
Fatigue
Lights (Photosensitive 3%)
Alcohol
Missing medication
Coffee
Nicotine
What are the investigations for a seizure?
CT Scan - First Seizure
MRI
EEG – electroencephalogram
Blood tests – to investigate underlying electrolyte cause
low glucose (hypoglycaemia) low sodium (hyponatraemia)
