Other Flashcards
Lacunar Stroke:
usually caused by…
associated with…
pathology…
- caused by occlusion of a single small penetrating artery
- long-standing HTN or DM
- lipohyalinosis or microatheroma and narrowing
Supplies the internal capsule + basal ganglia + corona radiata:
Lenticulostriate branches of the MCA
Pure motor hemiparesis:
MC caused by…
infarction of contralateral internal capsule
can be seen with infarct of corona radiata or pons
Pure motor hemiparesis:
s/s?
not present?
face arm and leg are equally affected
No evidence of sensory loss, homonymous hemianopia, aphasia, or hemineglect
Supplies the thalamus…
Thalamoperforate branches of the PCA
Pure sensory:
MC caused by…
infarction of the thalamus
Pure sensory:
S/s?
- Sensory loss throughout the contralateral side (but partial hemisensory defects may occur)
- Sensation is decreased for all sensory modalities w/ NO other neurological deficits
- Abnormal sensations such as “pins and needles” or skin tightness
What is Dejerine-Roussy Syndrome?
Tx?
Complication of thalamic infarction
- Severe intractable pain and allodynia (pain produced by tactile stimuli) on the effected side
gabapentin or TCA
Vascular infarct associated with sensorimotor stroke?
What structures are affected?
Paramedian penetrating branches of the basilar artery supplying the pons
Infarction MC in pons, internal capsule or corona radiata
Dysarthria Clumsy Hand Syndrome:
Infarction of…
s/s…
internal capsule or pons
dysarthria, UE ataxia, facial weakness, dysphagia, weakness in UE/LE
Cause of NEUROCYSTICERCOSIS?
Buzzwords?
Pork tapeworm (taenia solium)
Seizure + Mexico (Guatemala, etc)
Neurocysticercosis:
s/s?
complications?
occipital HA + Sz + focal signs (subacute onset)
- can obstruct ventricles
- can predispose to srtoke (arteritis –> clots)
Neurocysticercosis:
Dx?
- ELISA
- CT w/ multiple calcifications and space occupying lesions
- swiss cheese appearance on MRI
Neurocysticercosis:
Tx?
- Give steroids to decrease ICP
- Sz meds
- albendazole and praziquantil
- Shunt if CSF not flowing
Edema highlighted on T2-FLAIR =
chronic, inflammatory condition
substitution of one letter for another (wife -> wafe)
substitute one word of same type for another (wife vs mom)
Literal
semantic
PPx of meningococcal and H flu:
rifampin or cipro
Lesion of the superior part of SNS causes…
miosis + enophthalmos + anhidrosis
Horner’s syndrome
SNS to eye originates in… (brain structure)
Then what path does it follow?
hypothalamus
exits spinal cord with T1 –> enters Cervical Sympathetic Chain –> attaches to ICA
Tumor in chest wall will catch which cord first?
medial
Tingling or numbness above the wrist is caused by…
Tingling or numbness in hand, 5th digit and half of 4th…
root or cord lesion
ulnar nerve
Causes of Horner's according to pathway: Brainstem (3): Cervical Cord (2): T1 Root (2): ICA (2) :
Brainstem: Glioma + Infarction + Syringobulbia
Cervical Cord: Glioma + Syringomyelia
T1 Root: Neurofibroma + Brachial Plexus lesion
ICA: Occlusion + Dissection
(also: cluster HA, pancoast tumor)
Brain Death criteria?
- Clinical/neuroimaging evidence of acute CNS problem compatible with brain death
- Exclusion of complicating medical condition that may confound clinical assessment (eg metabolic)
- No drug intoxication or poisoning
- Core temp of 32 ̊C (90 ̊F)
Cardinal findings in brain death?
- coma (no cerebral motor response to pain)
- absent brainstem reflexes (pupils, EOM, facial sensation and motor resp, gag reflex)
- apnea testing (core of 36.5’C, SBP of 90, euvolemic, normal arterial PO2)