Neurology Flashcards
Congential Hydrocephalus
Often due to an intrauterine infection causing adhesions leading to CSF outflow obstruction
Presents with large head, bulging fontanelles, ‘sunset’ eyes and a skull which transilluminates
Flow of CSF
From the choroid plexi in the lateral ventricles to the third via the foremen of Munro –> to the fourth by the aqueduct of sylvius –> out of the foremen of luskha (laterally) and of magendie (midline) into the subarachnoid space. It is eventually reabsorb end through the arachnoid granular ions
Primary causes of hydrocephalus
Primary –> congenital (Arnold-chiari malformation, dandy walker syndrome, poor development/atresia of the aqueduct or foramina, intrauterine infection eg. toxoplasmosis)
Acquired –> expanding lesion restricting outflow, post meningitis adhesions particularly TB
Secondary causes of hydrocephalus
Reduction in brain tissue –> dementia
Infarction
GPI
Classification of hydrocephalus
External –> excess CSF in the subarachnoid space, not the ventricles
Communicating –> free flow of CSF in and out of the ventricles
Non communicating –> no free flow of CSF in/out of ventricles
Compensatory–> increased CSF due to brain tissue loss
Arnold-chiari malformation
This is where there is a prolongation of the cerebellum and medulla which bulges through the foremen magnum causing an obstruction of the flow of CSF
Causative organisms of cerebral abscesses
Streptococcus, staphylococcus, enterobacter, Bacteroides, diphtheria or coliforms
Can also be TB or fungal
Due to haematogenous spread from, most commonly inner ear or sinus infections.
Causes of Bacterial meningitis
Meningococcus Haemophilus Strep pneumoniae E. coli Treponema pallium or TB
Causes of viral meningitis
HSV or VZV echovirus Coxsackie EBV or CMV Mumps
Tumours which commonly metastasise to the brain
Small cell carcinoma of the lung Breast Kidney GI Melanoma
Progressive supranuclear palsy (PSP)
progressive disease that can present similarly to PD. presents with: gaze palsy,
falls and general postural instability at first
later there is more general dementia and aphasia
multiple system atrophy (MSA)
Progressive dementing disease similar to PD
presents with movement, balance and autonomic dysfunction with sphincter involvment
cerebellar signs
Wilson’s disease
autosomal recessive genetic disorder where copper builds up in tissues –> manifests as neurological, psychiatric and liver symptoms.
Signs of Cerebellar disease
Dysarthria
Ataxia (gait, intention tremor, dysmetria, dysdiadochokineia, heel-shin ataxia)
Nystagmus
Causes of cerebellar ataxia
Multiple sclerosis Alcohol Stroke/space occupying lesion Hereditary (friedreich's) Endocrine (hypothroidism) Drugs (phenytoin)
