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Survival Guide Flashcards

1
Q

Anton syndrome

A

Bilateral occipital lobe strokes Bilateral PCA or top of the basilar syndrome Visual deficit without recognition of blindness (visual agnosia)

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2
Q

Balint syndrome

A

Bilateral PCA (parietal-occipital) Loss of voluntary but not reflexive eye movements

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3
Q

Claude’s syndrome

A

Dorsal midbrain syndrome Ipsilateral CNIII palsy with contralateral ataxia

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4
Q

Dejerine syndrome

A

Medial medullary syndrome Basilar artery, vertebral artery, anterior spinal artery CL spastic weakness that spares face (pyramidal tracts), loss of vibration/position sense (medial lemniscus), ipsilateral tongue weakness (CN XII nucleus)

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5
Q

Dejerine-Roussy syndrome

A

PCA thalamic perforators Hemisensory loss Hemibody pain

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6
Q

Foville’s syndrome

A

Inferior medial pontine syndrome Basilar artery perforators CL weakness (corticospinal), facial weakness (CN VII nucleus), lateral gaze deficit (CV VI nucleus), decreased sensation/vibration sense (medial lemniscus)

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7
Q

Gerstmann syndrome

A

Dominant parietal lobe (MCA) Agraphia Acalculia L-R confusion Finger agnosia Ideomotor apraxia

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8
Q

Locked in syndrome

A

Basilar artery Paralysis of all movement except vertical gaze and eyelid opening (supranuclear ocular motor pathway preserved) Sensation and consciousness preserved (reticular formation spared)

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9
Q

Marie-Foix syndrome

A

Lateral inferior pontine syndrome AICA occlusion Ipsilateral ataxia (cerebellar tract), nausea, vertigo, decreased hearing (vestibular nucleus), CL hemiparesis (corticospinal tract), ipsilateral facial weakness (facial nucleus), ipsilateral loss of facial sensation (spinal trigeminal nucleus), CL hemihypesthesias (spinothalamic tract)

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10
Q

Millard-Gubler syndrome

A

Ventral pontine syndrome Basilar artery perforators Base of pons syndrome CL weakness (corticospinal tract), diplopia, strabismus, loss of extroversion (CN VI), ipsilateral facial weakness ( CN VII)

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11
Q

Raymond syndrome

A

Ventral pontine syndrome Perforators of basilar artery Lateral gaze deficits (CN VI), weakness (pyramidal tract)

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12
Q

Top of the basilar syndrome

A

Sudden onset of AMS, ophthalmoplegia, papillary, and visual field deficit (homonymous hemianopsia) Generally embolic or post-angio stent complications

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13
Q

Broca’s area

A

Located in the inferior frontal gyrus of dominant hemisphere, anterior to motor cortex for mouth/tongue MCA territory

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14
Q

Wernicke’s area

A

Located in superior temporal gyrus

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15
Q

Function of angular gyrus

A

Involved in visual function and in the dominant hemisphere (usually the left), functions in language, specifically comprehension of writing

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16
Q

Signs/symptoms of conductive aphasia

A

Difficulties with repetition

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17
Q

Lesion producing semantic aphasia

A

Atrophy of the anterior temporal lobe

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18
Q

Signs and symptoms of semantic aphasia

A

No knowledge of word meaning, semantic paraphasias, no memory deficits, prosopagnosia, alexia, later may develop behavioral changes

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19
Q

Definition of prosopagnosia

A

Inability to recognize familar faces

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20
Q

Definition of anomia

A

Inability to name an object when presented

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21
Q

Definition of alexia

A

Inability to read

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22
Q

Definition of agnosia

A

Inability to recognize and identify objects or persons

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23
Q

Definition of agraphia

A

Inability to compose written language

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24
Q

Foster Kennedy syndrome signs/symptoms

A

Ipsilateral anosmia, ipsilateral scotoma with optic atrophy, contralateral papilledema

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25
Q

Location and function of super nuclear gaze center

A

Located in the frontal lobe and initiates saccadic eye movement to the contralateral side

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26
Q

Lesion of the super nuclear gaze center produces…

A

Deviation to the affected side

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27
Q

Function of the pontine gaze center

A

Directs eye movement to the ipsilateral side

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28
Q

Lesion of pontine gaze center produces…

A

Eye deviation to the contralateral side

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29
Q

Lesion of the MLF produces..

A

Loss of adduction of the ipsilateral eye, and nystagmus of the contralateral eye on abduction

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30
Q

Gradenigo syndrome

A

Otalgia (ophthalmic branch of trigeminal nerve), ipsilateral paralysis of abducens nerve, otitis media/mastoiditis (involving apex of petrous temporal bone)

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31
Q

Tolosa-Hunt syndrome

A

Granuloma of superior orbital fissure required for dx Painful, unilateral ophthalmoplegia, pupil sparring

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32
Q

Foix syndrome

A

Syndrome of superior orbital fissure Ophthalmoplegia, corneal anesthesia, proptosis, pupillary dilation

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33
Q

Tonic (Adie’s pupil)

A

Postganglionic parasympathetic interruption (ciliary ganglion) Loss of direct or consensual light reflex, light-near dissociation

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34
Q

Marcus-Gunn pupil

A

Afferent pupillary defect Consensual reflex stronger than direct

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35
Q

Auditory agnosia: lesion and definition

A

Right temporal lobe lesion Inability to interpret sounds

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36
Q

Amusia: lesion and definition

A

Right temporal lobe lesion Inability to interpret music

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37
Q

Significance of lipid/lactate in MR spec

A

Inflammation, necrosis, anaerobic glycolysis

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38
Q

Significance of NAA in MR spec

A

Neuronal viability

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39
Q

Significance of creatine in MR spec

A

Energy metabolism, useful reference peak as generally stable

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40
Q

Significance of glutamine/glumatate

A

Neuronal damage (astrocytes), neurotransmitters

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41
Q

Significance of choline

A

Membrane turnover (phospholipid synthesis)

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42
Q

Spinal shock

A

Transient flaccid paralysis and areflexia after acute spinal cord injury, which transitions into spasticity in 1-2 weeks

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43
Q

Watershed area of the spine

A

Mid-thoracic

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44
Q

Definition of Schmorl’s nodes

A

Herniation of the nucleus pulposus into the end plate Associated with endplate fracture

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45
Q

Definition of AA impaction (basilar invagination)

A

Subluxation of the dens through the foramen magnum leading to brainstem compression

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46
Q

Symptoms of basilar invagination

A

Myelopathy, HA, nystagmus, cranial neuropathies

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47
Q

Definition of lateral recess syndrome

A

Compression of nerve root in lateral recess between hypertrophied superior articular facet, pedicle, and inferior vertebral body

48
Q

Foix-alajouanine syndrome

A

Thrombosis of spinal cord AVM Necrosis of gray>white matter Presents with subacute myelopathy

49
Q

Definition of transverse myelitis

A

Sudden onset of autoimmune demyelination or inflammation across one spinal cord segment

50
Q

Etiology of transverse myelitis

A

Lupus, postinfectious viral or bacterial, vaccinations, Bechet’s syndrome, MS

51
Q

Presentation of transverse myelitis

A

Sensory level, weakness, pain, paralysis, urinary incontinence

52
Q

Treatment of transverse myelitis

53
Q

Klippel-Feil syndrome

A

Congenital fusion of two or more cervical vertebrae (usually involves C2-3)

54
Q

Common location for mycotic aneurysms

A

MCA distribution

55
Q

More common location for fusiform aneurysms

A

Vertebrobasilar system

56
Q

Symptoms of SAH

A

HA, nausea, vomiting, meningismus, photophobia, confusion, LOC, coma

57
Q

Possible localizing signs for ACOM aneurysms

A

BLE weakness, numbness

58
Q

Possible localizing signs for MCA bifurcation aneurysms

A

Contralateral weakness, aphasia (left), or hemi-neglect (right)

59
Q

Possible localizing sings for basilar tip aneurysms

A

Vertical ophthalmoplegia

60
Q

Possible localizing signs for vertebral-PICA junction aneurysms

A

Wallenberg’s, vertigo, Horner’s, sensory deficits

61
Q

Possible localizing signs for ICA-PCOM junction aneurysms

A

Ipsilateral CN III palsy (pupil involving)

62
Q

Signs/symptoms of venous sinus thrombosis

A

HA, nausea, vomiting, seizures, hemiparesis, CN dysfunction, papilledema, blurred vision, AMS

63
Q

Diagnosis of venous sinus thrombosis

A

CT (“delta sign” looking at sagittal sinus)

64
Q

Treatment of venous sinus thrombosis

A

Heparin anticoagulation, +- thrombolytics, AVOID steroids, control BP, monitor ICP

65
Q

Cavernous hemangioma (AKA cavernous malformation, cavernoma)

A

Low flow, low pressure vascular malformations

66
Q

Presentation of cavernomas

A

Seizures (60%), progressive neuro deficit (50%), and hemorrhage (20%), or hydrocephalus

67
Q

Location of cavernomas

A

Mostly supratentorial

68
Q

Radiographic characteristics of cavernomas

A

Flow voids on MRI GRE is most sensitive for hemorrhage Well circumscribed Enhances with contrast T2 may have a dark rim from hemosiderin deposition

69
Q

Pathology of cavernomas

A

Irregular vasculature with no intervening brain “popcorn or mulberry” apperance

70
Q

Pathophysiology of moyamoya

A

Progressive occlusion of one or both supraclinoid ICAs, M1 MCAs, A1 ACAs, (and rarely P1 PCAs) resulting in a “puff of smoke” appearance of dilated capillary lenticulostriate collateral vessels

71
Q

Presentation of amyloid angiopathy

A

Presents as lobar intraparenchymal hemorrhage

72
Q

Common location for intraparenchymal hemorrhages in amyloid angiopathy

A

Frontoparietal, corticomedullary junction

73
Q

Pathology of amyloid angiopathy

A

Deposition of beta amyloid in the media and adventitia of small and mid-sized arteries

74
Q

Osler-Weber-Rendu disease

A

AVMs of lung, liver, brain, and spine

75
Q

Symptoms/signs of Osler-Weber-Rendu disease

A

In addition to AVMs, patients develop telangiectasias of skin, mucosa (epistaxis)

76
Q

Wyburn-Mason syndrome

A

Multiple intracranial AVMs along the visual pathways (including optic tract, midbrain), AVMs (including retina), and facial cutaneous vascular nevi

77
Q

Signs/symptoms of Wyburn-Mason syndrome

A

Optic nerve atrophy, seizures, strokes, SAH

78
Q

Blue rubber bleb nevus syndrome

A

Vascular malformations of skin, GI tract, CNS (hemangiomas, venous angiomas, sinus pericrani)

79
Q

Signs/symptoms of blue rubber bleb nevus syndrome

A

Anemia from GI bleeds, nevi on arms/trunk, palms, fractures (from bone hemangiomas)

80
Q

Definition of Wallerian degeneration

A

Process of axonal degeneration distal to the site of injury or transection; occurs in both the CNS and PNS

81
Q

Symptoms of occipital neuralgia

A

HA involving the posterior occiput in the greater or lesser occipital nerve distribution

82
Q

Contents of carpal tunnel

A

Flexor digitorum superficialis and profundus tendons, flexor pollicis longus tendon, and the median nerve

83
Q

Wartenburg’s sign seen in ulnar nerve entrapment

A

5th finger has position of abduction secondary to unopposed ulnar insertion of extensor digiti quinti

84
Q

Duchenne’s sign seen in ulnar nerve entrapment

A

Clawing of medial 2 digits

85
Q

Froment’s sign seen in ulnar nerve entrapment

A

On attempt to adduct the joint, will flex the finger

86
Q

Classic triad of symptoms in Parkinson’s disease

A

Resting tremor (4-8 Hz/second), cogwheel rigitidy, and bradykinesia

87
Q

C5 myotome (motor, reflex, sensory)

A

Motor - Deltoid (shoulder abduction) Reflex - Bicep tendon Sensory - Lateral upper arm

88
Q

C6 myotome (motor, reflex, sensory)

A

Motor - Bicep, extensor carpi ulnaris Reflex - Brachioradialis Sensory - Radial forearm, thumb and index finger

89
Q

C7 myotome (motor, reflex, sensory)

A

Motor - Triceps, flexor carpi ulnaris/radialis Reflex - Trcieps Sensory - Middle finger

90
Q

C8 myotome (motor, reflex, sensory)

A

Motor - Finger flexion (grip) Reflex - None Sensory - Ulnar forearm, ring and little finger

91
Q

T1 myotome (motor, reflex, sensory)

A

Motor - Interossei (finger abduction) Reflex - None Sensory - Upper medial forearm and medial arm

92
Q

L2 myotome (motor, reflex, sensory)

A

Motor - Psoas Reflex - None Sensory - Anterio-med thigh

93
Q

L3 myotome (motor, reflex, sensory)

A

Motor - Quads Reflex - None Sensory - Medial thigh around knee

94
Q

L4 myotome (motor, reflex, sensory)

A

Motor - Tibialis anterior (dorsiflex and foot inversion) Reflex - Patellar Sensory - Medial foot

95
Q

L5 myotome (motor, reflex, sensory)

A

Motor - EHL Reflex - None Sensory - Dorsum foot

96
Q

S1 myotome (motor, reflex, sensory)

A

Motor - Gastrocnemius, peroneus longus and brevis (foot eversion) Reflex - Achilles Sensory - Lateral foot

97
Q

S2,3,4 myotome (motor, reflex, sensory)

A

Motor - External bladder sphincter Reflex - Bulbocavernosus Sensory - Perianal area

98
Q

Typical location of intraventricular colloid cyst

A

Foramen of Monro/third ventricle

99
Q

Typical location of intraventricular meningioma

A

Trigone of lateral ventricle

100
Q

Typical location of intraventricular choroid

A

Fourth ventricle

101
Q

Typical location of intraventricular ependymoma

A

Lateral ventricle (more common in children) and 4th ventricle

102
Q

Typical location of intraventricular neurocytoma

A

Lateral ventricle (involving septum pellucidum)

103
Q

Typical location of intraventricular mets

A

Lateral ventricle, ependyma, and choroid plexus

104
Q

Typical imaging features of sellar/parasellar pituitary macroadenoma

A

Enlarged sella turcica, strong enhancement, sometimes hemorrhagic (apoplexy)

105
Q

Typical imaging features of sellar/parasellar meningioma

A

Broad dural base with tail, enhancement along planum sphenoidale, hyperostosis

106
Q

Typical imaging features of sellar/parasellar Schwannoma

A

T1-hypo and T2-hyperintense, strong enhancement (CN V most common)

107
Q

Typical imaging features of sellar/parasellar chordoma

A

Bone destruction on CT, heterogenous signal and enhancement on MRI, respects dura

108
Q

Typical imaging features of sellar/parasellar chondrosarcoma

A

Bone destruction and calcification on CT, T2-hyperintense on MRI

109
Q

Typical imaging features of sellar/parasellar Rathke’s cleft cyst

A

T1-hyperintense, smooth peripheral enhancement

110
Q

Typical imaging features of sellar/parasellar dermoid

A

Hypodense on CT and T1-hyperintense on MRI

111
Q

Typical imaging features of sellar/parasellar epidermoid

A

Isodense to CSF on CT and MRI T1 and T2 imaging, brighter than CSF on FLAIR and DWI

112
Q

Typical imaging features of sellar/parasellar tuber cinerium

A

Grey matter isointense on T1 and T2 hamartoma hyperintense

113
Q

Typical imaging features of sellar/parasellar optic glioma

A

Thickening of chiasm, spread along optic pathways

114
Q

Typical imaging features of sellar/parasellar germ cell tumor

A

Located in midline, intense enhancement, often with pineal germinomas

115
Q

Commonly calcified lesions

A

Oligodendrogliomas (90%), choroid plexus tumors (papillomas), ependymoma, central neurocytoma, meningioma, craniopharyngioma, teratoma, chordoma

116
Q

Commonly hemorrhagic lesions

A

GBM, oligodendrogliomas, mets (melanoma, lung, breast)

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