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MS4 - Neurology > Raised ICP > Flashcards

Raised ICP Flashcards

1
Q

Signs of raised ICP

A

Headache

Vomiting

Papilloedema

Reduced GCS

Seizures

Pupil changes

Cushing’s triad

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2
Q

When is raised ICP headache worse

A

Waking

Lying down

Bending forward

Coughing

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3
Q

Signs of space occupying lesion

A

Raised ICP

Seizures

Focal neurology

Subtle personality change

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4
Q

Causes of SOL

A

Tumour

Aneurysm

Abscess

Chronic subdural haematoma

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5
Q

Types of primary brain tumour

A

Astrocytoma

Glioblastoma

Oligodendroglioma

Ependymoma

Meningioma

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6
Q

Metastatic brain tumours

A

Breast

Lung

Melanoma

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7
Q

Mx of hydrocephalus

A

Ventriculo-Peritoneal shunt

(VP shunt)

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8
Q

Third ventrical colloid cyst definition

A

Congenital cysts

Present in adulthood

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9
Q

Presentation of Third ventrical colloid cysts

A

Amnesia

Headache

Incontinence

Bilateral paraesthesia

Blunted consciousness

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10
Q

Mx of Third ventrical colloid cyst

A

Excision

VP shunt

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11
Q

Idiopathic intracranial hypertension presentation

A

Same as SOL but absence of mass

Narrowed visual fields

Consciousness and cognition preserved

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12
Q

Typical patients with idiopathic intracranial hypertension

A

Obese women

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13
Q

Causes of idiopathic intracranial hypertension

A

Unknown

Secondary to venous sinus thrombosis

Drugs

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14
Q

Drug causes of idiopathic intracranial hypertension

A

Tetracycline

Nitrofurantoin

Vit A

Isotretanoin

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15
Q

Mx of idiopathic intracranial hypertension

A

Weight loss

Acetazolamide

Loop diuretics

Prednisolone

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16
Q

Prognosis of idiopathic intracranial hypertension

A

Often self limiting

10% permanent significant visual loss

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17
Q

Mx options for visual disturbance

A

Lumbar-peritoneal shunt

Optic nerve sheath fenestration

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18
Q

Temporal lobe focal neurology

A

Dysphagia

Contralateral homonymous hemianopia

Amnesia

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19
Q

Frontal lobe focal neurology

A

Hemiparesis

Personality changes

Broca’s dysphasia

Unilateral anosmia

Perseveration

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20
Q

Parietal lobe focal neurology

A

Hemisensory loss

Dysphasia

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21
Q

Occipital lobe focal neurology

A

Contralateral visual field defects

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22
Q

Cerebellum focal neurology

A

DANISH P

Dysdiadochokinesis

Ataxia

Nystagms

Intention tremor

Slurred speech

Hypotonia

Past pointing

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23
Q

Sx of cerebral abscess

A

Raised ICP

Fever

Coma

Sepsis

24
Q

Mx of cerebral abscess

A

Urgent neurosurgery referral

Rx raised ICP

25
Q

Cushing’s triad definition

A

Late sign of raised ICP

Worried about coning

26
Q

Cushing’s triad

A

Bradycardia

HTN

Cheyne-Stokes respiration

27
Q

Cheyne-Stokes respiration

A

Irregular breathing

28
Q

Causes of raised ICP

A

Tumours

Head injury

Haemorrhage

Infection

Hydrocephalus

Status epilepticus

29
Q

Mx of raised ICP

A

Urgent neurosurgery referral

Lift head of bed

Hyperventilate

Osmotic agents (mannitol)

Fluid restriction

30
Q

Reason for hyperventilation to rx raised ICP

A

Reduced CO2

Cerebral vasoconstriction

Reduced ICP immediately

31
Q

Level of fluid restriction for raised ICP

A

< 1.5 L/day

32
Q

Uncal herniation

A

lateral supratentorial mass

3rd nerve palsy

33
Q

Cerebellar tonsil herniation

A

Cerebellar tonsils through foramen magnum

34
Q

Sx of cerebellar tonsil herniation

A

Ataxia

6th nerve palsy

Upgoing plantars

LOC

Irregular breathing

35
Q

Subfalcian (cingulate) herniation

A

Cingulate gyrus forced under rigid falx cerebri

ACA compressed causes stroke

36
Q

Definition of encephalitis

A

Infection of brain

37
Q

Sx of encephalitis

A

Confusion

Reduced GCS
Fever

Headache

Focal neurology

Seizures

38
Q

Viral causes of encephalitis

A

HSV 1 and 2

Arboviruses

CMV

EBV

VZV

HIV seroconversion

Measles

Mumps

Japanese B encephalitis

I can’t even think of any more viruses

39
Q

Non viral causes of encephalitits

A

Bacterial meningitis

TB

Malaria

Lyme disease

Leptospirosis

40
Q

Ix for encephalitis

A

Blood cultures

Serum viral PCR

Malaria film

CT

LP

41
Q

CT findings in encephalitis

A

Focal bilateral temporal lobe involvement suggestive of HSV encephalitis

42
Q

LP findings in encephalitis

A

Increased protein

Increased lymphocytes

Decreased glucose

Send CSF for viral PCR

43
Q

Mx of encephalitis

A

Aciclovir 14 days

44
Q

Causes of subarachnoid haemorrhage

A

Saccular aneurysm rupture

Arteriovenous malformation

Indiopathic

45
Q

Associations of berry aneurysms

A

Polycystic kidney disease

Aortic coarctation

Ehlers-Danlos syndrome

46
Q

RFs for subarachnoid haemorrhage

A

Smoking

Alcohol misuse

HTN

Bleeding disorders

47
Q

Ehlers-Danlos syndrome features

A

Hypermobile joints

Increased skin elasticity

48
Q

Sx of subarachnoid haemorrhage

A

Sudden onset

Thunderclap occipital headache

Vomiting

49
Q

Signs of subarachnoid haemorrhage

A

Neck stiffness

Seizure

Collapse

50
Q

Sentinel headache definition

A

Early small warning headache before subarachnoid haemorrhage

Warning leak

51
Q

Ix for subarachnoid haemorrhage

A

CT within 48 hrs

LP > 12 hrs if CT negative

52
Q

LP findings in subarachnoid haemorrhage

A

Xanthochromia is pathopneumonic

CSF is yellow after several hrs from Hb breakdown

Shows blood in CSF is not from LP

53
Q

Mx of subarachnoid haemorrhage

A

Neurosurgery referral

Hydration

Nimodipine

Endovascular coiling

54
Q

Use of nimodipine for subarachnoid haemorrhage

A

Ca channel blocker

Reduces cerebral vasospasm and therefore cerebral ischaemia

55
Q

Complications of subarachnoid haemorrhage

A

Rebleeding

Cerebral ischaemia

Hydrocephalus

Hyponatraemia

MS4 - Neurology (11 decks)

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