Neurology 2 Flashcards
If someone has episodic memory loss what is the likely diagnosis?
Alzheimers
If someone has semantic memory loss, what is the likely diagnosis?
Semantic memory dementia: Frontal lobe variant
If someone is unable to maintain attention, what is the likely cause?
Delirium
How are SAHs graded?
Via the GCS score
What is the product being looked for in the CSF to diagnose a SAH?
Xanthochromia
Outwith a CT, what other investigations should be carried out in a SAH?
U&Es
- hyponatremia usually present - more brain swelling
ECG
- catecholamine release
Troponin levels
- in case of cardio damage
Echo of heart
What drug is given in SAH to prevent delayed ischemia?
Nimodipine
- Ca2+ channel blocker
out with a thunderclap headache, what other features are found in SAH?
Meningism
Seizures
Vomiting
Photophobia
Terson’s Syndrome
- vitreous hemorrhage
Papilledema
What nerves can the brain sense itself?
5th
9th
What are the major types of headache?
Primary
- headache and underlying features are cause
- migraine
- tension
Secondary
- subarachnoid
- meningitis
What are the stages of a migraine?
Prodrome
- mood disturbance
- photophobia
Aura
- scotoma
- flashing lughts
Migraine attack
- pain
Postdrome
- mild headache following
What is the pathophysiology of migraines?
Aura:
- wave of cortical depression causing depressed activity from the occipital lobe moving anteriorly
Migraine pain:
- trigeminovascular system
- large intracranial vessels supplied by V1.
release of:
- CGRP
- Substance P
- Serotonin
What is the management of migraines?
Avoid triggers
High dose aspirin
Triptans
Anti - emetics
- metoclopramide
Prophylaxis
- propranolol
- amitriptyline
- valproate
What are the red flag symptoms for headaches?
> 50 years old
Thunderclap
Focal/ Non-focal symptoms
Intracranial pressure signs
Early morning headaches
Previous history of cancer
Systemic symptoms
- weight loss
Temporal artery
- jae claudication
What is the risk with using opioids in headache pain?
Medication overuse headaches
Whats the medical term for cluster headaches?
Trigeminal Autonomic Cephalgias
Where are most berry aneurysms located?
Anterior communication/ anterior cerebral artery junction
Where is second most common area for berry aneurysm?
Bifurcation of the middle cerebral artery
What are some other causes of SAH outwith berry aneurysm?
AVM
Coagulopathies
Trauma
What are some risk factors for SAH?
Smoking
Female
Hypertension
Polycystic disease
What are some complications following a SAH?
Hemorrhage
- within 72 hours
Delayed ischemia
- blood vessel constriction
Hyponatremia
Hydrocephalus
- obstruction to CFS
seizures
DVT
Whats the causes of hyponatremia in SAH patients?
Cerebral salt wasting
SIADH
to do with the total body weight of the patients.
What the management of SAH?
Referral to neurosurgical unit
Supportive stockings
Fluids - saline
Nimodipine
dihydrocodeine
Phenytoin if seizures
