Neurology Flashcards
Intervention in TBI that has been shown to improve outcomes more than any other
Preventing hypotension
Lorazepam dose of status epilepticus
0.1 mg/kg
Findings in cushings reflex
Bradycardia
Widened pulse pressure
irregular breathing
Spinal cord syndrome where there is total loss of vibration, proprioception, pain and temperature, and motor loss bilaterally below the level of the lesion
Transverse cord syndrome
Spinal cord syndrome where there is loss of motor and proprioception below the ipsilateral side of the lesion and loss of pain and temperature below the contralateral side
Hemicord lesion aka Brown-Sequard
Spinal cord syndrome where there is upper extremity motor and sensory loss in a cape like distribution
Central cord lesion
Spinal cord syndrome where there is loss of vibration and position below the level of the lesion bilaterally
Posterior cord syndrome
Spinal cord syndrome where there is loss of motor function and pain/temperature below the level of the lesion bilaterally
Anterior cord syndrome
Condition where there is autoimmune demyelination of the white mater following an infection
Acute Disseminated Encephalomyelitis (ADEM)
First line treatment for ADEM
solumedrol
Second line treatment for ADEM
Plasmapheresis
Most sensitive test for spinal abscess
MRI
Condition post stroke where there is a large ischemic area and risk of herniation
Malignant middle cerebral artery syndrome
Only treatment for malignant middle cerebral artery syndrome that has been shown to reduce mortality
Hemicraniectomy
Test to check for cerebral vasospasm
transcranial doppler
Test to look for large vessel occlusion in stroke
CT or MR angio with perfusion or diffusion imaging
ICP value above which there are worse outcomes
> 20
CPP associated with worse outcomes
> 70
In elevated CPP what are the 2 treatment options
Lower MAP or raise ICP so long as the ICP does not cross > 20
Variant of GBS that has early cranial nerve dysfunction and respiratory failure
Miller fisher
Treatment for GBS
IVIG and/or plasmapheresis
Treatment for dysautonomic shock in GBS
Midodrine and fludrocortisone
Antiepileptic given for 7 days in TBI to prevent seizures
Phenytoin
Name of the protein responsible for parkinsons and lewy body dementia
Alpha-synuclein
Treatment that improves mortality in intraventricular hemorrhage
Intrathecal TPA until 85% of the blood has been reduced
Is there a difference between open and closed external ventricular drain in terms of mortality benefit?
No
What direction do eyes move in acute stroke
Toward the lesion and away from the hemiparesis
What direction do eyes move in seizures
Away from the lesion and toward the hemiparesis
2 causes of lymphocyte predominant CSF in meningitis
Listeria and TB
Can dialysis remove bone marrow particles in fat embolism?
No (no treatment works)
Memory loss and new intracerebral hemorrhage from microhemorrhages suggests what diagnosis
Cerebral amyloid angiopathy
Can anything prevent future strokes in cerebral amyloid angiopathy?
No
Platelet transfusion threshold in patient’s with intercerebral hemorrhage despite being on antiplatelet therapy
< 50k
What are the two mechanisms of vasoconstriction in patient’s who are at risk of herniation
Therapeutic hyperventilation and systemic cooling
To what level do you cool a patient to prevent herniation?
33C
To what level do you aim for CO2 in therapeutic hyperventilation to prevent brain herniation?
20
What autoimmune paraneoplastic syndrome is commonly associated with ovarian or testicular teratomas
anti-NMDA receptor encephalitis syndrome
What is the targeted temperature in TTM?
< 38C
