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Y3 Neurology > Pathology, Coning, Hydrocephalus & Trauma > Flashcards

Pathology, Coning, Hydrocephalus & Trauma Flashcards

1
Q

what is a red neuron

A

dying neuron after acute neuronal injury

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2
Q

what part of a neruon is lost in chromatolysis

A

Nissl body

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3
Q

what is chromatolysis also referred to as

A

axonal reaciton

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4
Q

what is gliosis

A

reactive hyperplasia or hypertrophy of astrocytes in response to damage/injury

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5
Q

what cell type in the brain proliferates in response to injury and aggregates around necrosis/damage?

A

microglia

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6
Q

which type of microglia are pro-inflammatory and which are anti-inflammatory

A

M1 pro-inflam, M2 anti-inflam

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7
Q

what is the term that describes a glutamate storm in the brain in response to hypoglycaemia or hypoxia and leads to apoptosis

A

excitotoxicity

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8
Q

what are the causes of global hypoxic brain damage

A

cardiac arrest, hypotension, shock

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9
Q

oedema occurs secondary to hypoxic brain damage. T or F

A

T

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10
Q

how is malignant HTN defined

A

a BP so high it causes end organ damage

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11
Q

what type of brain oedema occurs in hypothermia and intoxication and is often pre-morbid

A

cytotoxic oedema

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12
Q

what type of brain oedema occurs in hyponatraemia and SIADH due to BBB dysfunction

A

ionic/osmotic

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13
Q

what type of brain oedema occurs in trauma, tumour, inflam, infection and hypertensive encephalopathy

A

vasogenic oedema

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14
Q

what is the commonest cause of congenital hydrocephalus

A

aqueduct stenosis

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15
Q

what is communicating hydrocephalus

A

problem with CSF reabsorption

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16
Q

what is non-communicating hydrocephalus

A

obstruction within ventricular system

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17
Q

name a cause of communicating hydrocephalus

A

post-meningitis

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18
Q

what is hydrocephalus ex vacuo

A

compensatory after parenchyma loss

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19
Q

presentation of hydrocephalus

A

headache, vomiting, papilledema, gait disturbance

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20
Q

what additional signs are present in congenital hydrocephalus

A 
big head
shiny scalp 
visible scalp veins
sun setting
downward eyes
bulging eyes
trouble feeding
irritable
sleep
muscle stiffness
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21
Q

imaging choice in acute hydrocephalus

A

CT

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22
Q

imaging choice in non-acute hydrocephalus

A

MRI

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23
Q

acute management of hydrocephalus

A

IV mannitol

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24
Q

mechanism of acetazolamide

A

decreases CSF production

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25
Q

complications of hydrocephalus

A

brain herniation/coning, VI palsy

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26
Q

management of congenital hydrocephalus

A

LP lumboperitoneal shunt

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27
Q

an adult with a headache, N+V, absent upgase, blurred vision and a PMH of hydrocephalus is likely…

A

blocked shunt

28
Q

age range normal pressure hydrocephalus occurs in

A

elderly

29
Q

signs of normal pressure hydrocephalus

A

broad shuffling gate, reversible dementia, bladder incontinent

30
Q

what brain structure is enlarged in normal pressure hydrocephalus

A

ventricles

31
Q

investigations for normal pressure hydrocephalus

A

CT, CSF tap test

32
Q

management of normal pressure hydrocephalus

A

shunt

33
Q

signs of raised ICP

A

HA worse lying down/ coughing, N+V, mental change, seizure, stiff neck

also potential signs of complications eg. III palsy

34
Q

cushing’s triad can occur in raised ICP. what is cushing’s triad

A

Raised BP
Bradycardia
Irregular breathing

35
Q

does brain herniation occur in rapid or insidious changes in ICP

A

rapid

36
Q

what is coning

A

type of brain herniation where cerebellar tonsils are displaced through the foramen magnum

37
Q

complication of central herniations

A

VI palsy; diplopia

38
Q

what is the pattern in subfalcine herniations?

A

cingulate gyrus of frontal lobe herniates under falx cerebri

39
Q

what structure can be compressed in subfalcine aka cingulate herniations? and how does this present?

A

anterior cerebral artery

weakness/sensory leg problem

40
Q

what is the pattern in tentorial uncal herniations

A

medial temporal lobe herniates over tentorium cerebelli

41
Q

what is the 1st presentation of tentorial uncal herniations?

A

ipsilateral CN III palsy; unreactive pupil

42
Q

what is a later presentation of tentorial uncal herniations?

A

pyramidal compression; contralateral hemiparesis

43
Q

what is the pattern in tonsillar herniations?

A

cerebellar tonsils herniate through foramen magnum

44
Q

aetiology of tonsillar herniations

A

Arnold Chiari malformation or posterior fossa lesion

45
Q

how do tonsillar herniations present

A

stiff neck, decreased RR, decreased HR, increased BP

lecture may say cheyne stokes respiration but not sure if true

46
Q

what is the major cause of mortality in tonsillar herniations?

A

compress medullary resp centre which arrests respiration

47
Q

what is a transcalvarial herniation

A

herniation through defect in dura/skull

48
Q

do morphologic changes to the cns occur in chronic pain?

A

yes

49
Q

what type of pain is defined as ‘an appropriate physiologic response to painful stimuli via an intact nervous system’

A

nociceptive pain

50
Q

what type of pain is an inappropriate response due to nervous system dysfunction?

A

neuropathic pain

51
Q

what is allodynia?

A

pain elicited by a stimulus that wouldn’t normally cause pain

52
Q

what infection is linked to neuropathic pain?

A

HSV; post herpetic neuralgia

53
Q

what are the patterns of skull fractures

A

linear
depressed
compound/open

54
Q

what is the name of the injury that occurs at the time of trauma

A

primary impact

55
Q

is primary impact injury to neurons reversible?

A

no

56
Q

in primary impact brain injury, coup and contracoup are types of what?

A

contusion

57
Q

is secondary injury in brain trauma reversible?

A

potentially

58
Q

what is the name of the type of brain injury that can cause death or a vegetative state?

A

diffuse axonal injury

59
Q

a coma is a GCS of less than what

A

8

60
Q

is a coma due to brainstem or cortex dysfunction

A

brainstem

61
Q

what are the 2 patterns of rigidity in coma / brainstem dysfunction?

A

decorticate rigidity

decerebrate rigidity

62
Q

what type of rigidity in coma / brainstem dysfunction is more severe?

A

decerebrate rigidity

63
Q

where does damage occur in decerebrate rigidity

A

below red nucleus of the midbrain

64
Q

arms flexed, hands clenched, legs extended, feet inward - does describe decorticate rigidity or decerebrate rigidity?

A

decorticate rigidity

65
Q

head arched back, limbs extended - does describe decorticate rigidity or decerebrate rigidity?

A

decerebrate rigidity

Y3 Neurology (23 decks)

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