Neurology- Stroke & Brain Lesions

Question 1

S&S concussion

Answer 1

Headache (triggered by physical or cognitive exertion and visual tasks)
Light/ noise sensitivity
Cognitive impairment (confusion, difficulty concentrating)
Emotional changes
Sleep disturbances.

Question 2

Concussion

Answer 2

mild traumatic brain injury caused by axonal shearing from rapid rotational acceleration. Results in neurological disturbances but no structural intracranial injury

Question 3

Management of concussion.

Answer 3

neuroimaging no required for diagnosis but can rule out structural brain injury.

Symptomatic management
Physical and cognitive rest.

Question 4

Diagnosis: photophobia, sound sensitivity, diffuse headache with rapid eye movement between two points, Hx recent car accident

Answer 4

Concussion.

though migraine is typically associated with photophobia and noise sensitivity it is a unilateral not diffuse headache.

Question 5

Cushing Triad

Answer 5

Hypertension
Bradicardia
Irregular respirations

Cause: increased ICP

Question 6

Cushing reflex

Answer 6

Hemodynamic response to acutely increased ICP in attempts to restore perfusion.

1. Hypertension (sympathetic system activated) maintain cerebral perfusion pressure.
2. Bradycardia (parasympathetic response in baroreceptors)

Question 7

Prognosis of Cushing triad

Answer 7

poor. often indicated herniation is imminent

Question 8

Mechanism of increased ICP in hypoxic brain injury

Answer 8

Widespread neuronal necrosis leads to cerebral edema. Increases ICP and comprises small arterials further decreasing cerebral blood flow