passmed bits Flashcards
Where is the problem in bitemporal heminanopia?
Optic chiasm e.g. pit macroadenoma
Where is lesion in bitemporal heminanopia with upper quadrant defect> lower quad defect?
inferior chiasmal compression, commonly a pituitary tumour
Where is lesion in bitemporal heminanopia with lower quadrant defect > upper quad defect?
upper quadrant defect = superior chiasmal compression, commonly a craniopharyngioma
What is normal pressure hydrocephalus?
Reversible cause of dementia seen on elderly pts
Thought to be secondary to reduced CSF absorption in arachnoid villi
Causes of Normal pressure hydrocephalus?
May be secondary to head injury, SAH or meningitis
Features of normal pressure hydrocephalus?
Urinary incontinence
Dementia and Bradyphrenia
Gait abnormality- similar to Parkinson’s disease
Symptoms develop over a few months
What do you see on imaging of Normal pressure hydrocephalus?
hydrocephalus with ventriculomegaly in the absence of, or out of proportion to, sulcal enlargement
Management of normal pressure hydrocephalus?
Ventriculoperitoneal shunting
Complications of Ventriculoperitoneal shunting?
Seizures, infection and intracerebral haemorrhages
Affects around 10% of patients
What is the management of Guilian Barre syndrome?
Management:
conservative measures:
monitoring of ventilation (with serial spirometry and ABG) ± ventilation
reduce the risk of VTE (TEDs, LMWH), and protection of pressure areas.
Medical management is with intravenous immunoglobulin and, if ineffective, plasmapheresis.
What are important specific neurological investigations in suspected Guillain-Barré syndrome?
Lumbar puncture
Electromyelography/nerve conduction studies
SPinal and brain imaging - often performed to rule out other causes of symptoms, rather than being a useful assessment in Guillain-Barré syndrome
Blood tests to screen for biochemical causes of peripheral neuropathy (thyroid function, B12, inflammatory markers)
Muscle biopsy (not routine, but may be helpful to distinguish from a primary myopathy)
