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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
Location and function of super nuclear gaze center
Located in the frontal lobe and initiates saccadic eye movement to the contralateral side
26
Lesion of the super nuclear gaze center produces...
Deviation to the affected side
27
Function of the pontine gaze center
Directs eye movement to the ipsilateral side
28
Lesion of pontine gaze center produces...
Eye deviation to the contralateral side
29
Lesion of the MLF produces..
Loss of adduction of the ipsilateral eye, and nystagmus of the contralateral eye on abduction
30
Gradenigo syndrome
Otalgia (ophthalmic branch of trigeminal nerve), ipsilateral paralysis of abducens nerve, otitis media/mastoiditis (involving apex of petrous temporal bone)
31
Tolosa-Hunt syndrome
Granuloma of superior orbital fissure required for dx Painful, unilateral ophthalmoplegia, pupil sparring
32
Foix syndrome
Syndrome of superior orbital fissure Ophthalmoplegia, corneal anesthesia, proptosis, pupillary dilation
33
Tonic (Adie's pupil)
Postganglionic parasympathetic interruption (ciliary ganglion) Loss of direct or consensual light reflex, light-near dissociation
34
Marcus-Gunn pupil
Afferent pupillary defect Consensual reflex stronger than direct
35
Auditory agnosia: lesion and definition
Right temporal lobe lesion Inability to interpret sounds
36
Amusia: lesion and definition
Right temporal lobe lesion Inability to interpret music
37
Significance of lipid/lactate in MR spec
Inflammation, necrosis, anaerobic glycolysis
38
Significance of NAA in MR spec
Neuronal viability
39
Significance of creatine in MR spec
Energy metabolism, useful reference peak as generally stable
40
Significance of glutamine/glumatate
Neuronal damage (astrocytes), neurotransmitters
41
Significance of choline
Membrane turnover (phospholipid synthesis)
42
Spinal shock
Transient flaccid paralysis and areflexia after acute spinal cord injury, which transitions into spasticity in 1-2 weeks
43
Watershed area of the spine
Mid-thoracic
44
Definition of Schmorl's nodes
Herniation of the nucleus pulposus into the end plate Associated with endplate fracture
45
Definition of AA impaction (basilar invagination)
Subluxation of the dens through the foramen magnum leading to brainstem compression
46
Symptoms of basilar invagination
Myelopathy, HA, nystagmus, cranial neuropathies
47
Definition of lateral recess syndrome
Compression of nerve root in lateral recess between hypertrophied superior articular facet, pedicle, and inferior vertebral body
48
Foix-alajouanine syndrome
Thrombosis of spinal cord AVM Necrosis of gray\>white matter Presents with subacute myelopathy
49
Definition of transverse myelitis
Sudden onset of autoimmune demyelination or inflammation across one spinal cord segment
50
Etiology of transverse myelitis
Lupus, postinfectious viral or bacterial, vaccinations, Bechet's syndrome, MS
51
Presentation of transverse myelitis
Sensory level, weakness, pain, paralysis, urinary incontinence
52
Treatment of transverse myelitis
Steroids
53
Klippel-Feil syndrome
Congenital fusion of two or more cervical vertebrae (usually involves C2-3)
54
Common location for mycotic aneurysms
MCA distribution
55
More common location for fusiform aneurysms
Vertebrobasilar system
56
Symptoms of SAH
HA, nausea, vomiting, meningismus, photophobia, confusion, LOC, coma
57
Possible localizing signs for ACOM aneurysms
BLE weakness, numbness
58
Possible localizing signs for MCA bifurcation aneurysms
Contralateral weakness, aphasia (left), or hemi-neglect (right)
59
Possible localizing sings for basilar tip aneurysms
Vertical ophthalmoplegia
60
Possible localizing signs for vertebral-PICA junction aneurysms
Wallenberg's, vertigo, Horner's, sensory deficits
61
Possible localizing signs for ICA-PCOM junction aneurysms
Ipsilateral CN III palsy (pupil involving)
62
Signs/symptoms of venous sinus thrombosis
HA, nausea, vomiting, seizures, hemiparesis, CN dysfunction, papilledema, blurred vision, AMS
63
Diagnosis of venous sinus thrombosis
CT ("delta sign" looking at sagittal sinus)
64
Treatment of venous sinus thrombosis
Heparin anticoagulation, +- thrombolytics, AVOID steroids, control BP, monitor ICP
65
Cavernous hemangioma (AKA cavernous malformation, cavernoma)
Low flow, low pressure vascular malformations
66
Presentation of cavernomas
Seizures (60%), progressive neuro deficit (50%), and hemorrhage (20%), or hydrocephalus
67
Location of cavernomas
Mostly supratentorial
68
Radiographic characteristics of cavernomas
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
Pathology of cavernomas
Irregular vasculature with no intervening brain "popcorn or mulberry" apperance
70
Pathophysiology of moyamoya
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
Presentation of amyloid angiopathy
Presents as lobar intraparenchymal hemorrhage
72
Common location for intraparenchymal hemorrhages in amyloid angiopathy
Frontoparietal, corticomedullary junction
73
Pathology of amyloid angiopathy
Deposition of beta amyloid in the media and adventitia of small and mid-sized arteries
74
Osler-Weber-Rendu disease
AVMs of lung, liver, brain, and spine
75
Symptoms/signs of Osler-Weber-Rendu disease
In addition to AVMs, patients develop telangiectasias of skin, mucosa (epistaxis)
76
Wyburn-Mason syndrome
Multiple intracranial AVMs along the visual pathways (including optic tract, midbrain), AVMs (including retina), and facial cutaneous vascular nevi
77
Signs/symptoms of Wyburn-Mason syndrome
Optic nerve atrophy, seizures, strokes, SAH
78
Blue rubber bleb nevus syndrome
Vascular malformations of skin, GI tract, CNS (hemangiomas, venous angiomas, sinus pericrani)
79
Signs/symptoms of blue rubber bleb nevus syndrome
Anemia from GI bleeds, nevi on arms/trunk, palms, fractures (from bone hemangiomas)
80
Definition of Wallerian degeneration
Process of axonal degeneration distal to the site of injury or transection; occurs in both the CNS and PNS
81
Symptoms of occipital neuralgia
HA involving the posterior occiput in the greater or lesser occipital nerve distribution
82
Contents of carpal tunnel
Flexor digitorum superficialis and profundus tendons, flexor pollicis longus tendon, and the median nerve
83
Wartenburg's sign seen in ulnar nerve entrapment
5th finger has position of abduction secondary to unopposed ulnar insertion of extensor digiti quinti
84
Duchenne's sign seen in ulnar nerve entrapment
Clawing of medial 2 digits
85
Froment's sign seen in ulnar nerve entrapment
On attempt to adduct the joint, will flex the finger
86
Classic triad of symptoms in Parkinson's disease
Resting tremor (4-8 Hz/second), cogwheel rigitidy, and bradykinesia
87
C5 myotome (motor, reflex, sensory)
Motor - Deltoid (shoulder abduction) Reflex - Bicep tendon Sensory - Lateral upper arm
88
C6 myotome (motor, reflex, sensory)
Motor - Bicep, extensor carpi ulnaris Reflex - Brachioradialis Sensory - Radial forearm, thumb and index finger
89
C7 myotome (motor, reflex, sensory)
Motor - Triceps, flexor carpi ulnaris/radialis Reflex - Trcieps Sensory - Middle finger
90
C8 myotome (motor, reflex, sensory)
Motor - Finger flexion (grip) Reflex - None Sensory - Ulnar forearm, ring and little finger
91
T1 myotome (motor, reflex, sensory)
Motor - Interossei (finger abduction) Reflex - None Sensory - Upper medial forearm and medial arm
92
L2 myotome (motor, reflex, sensory)
Motor - Psoas Reflex - None Sensory - Anterio-med thigh
93
L3 myotome (motor, reflex, sensory)
Motor - Quads Reflex - None Sensory - Medial thigh around knee
94
L4 myotome (motor, reflex, sensory)
Motor - Tibialis anterior (dorsiflex and foot inversion) Reflex - Patellar Sensory - Medial foot
95
L5 myotome (motor, reflex, sensory)
Motor - EHL Reflex - None Sensory - Dorsum foot
96
S1 myotome (motor, reflex, sensory)
Motor - Gastrocnemius, peroneus longus and brevis (foot eversion) Reflex - Achilles Sensory - Lateral foot
97
S2,3,4 myotome (motor, reflex, sensory)
Motor - External bladder sphincter Reflex - Bulbocavernosus Sensory - Perianal area
98
Typical location of intraventricular colloid cyst
Foramen of Monro/third ventricle
99
Typical location of intraventricular meningioma
Trigone of lateral ventricle
100
Typical location of intraventricular choroid
Fourth ventricle
101
Typical location of intraventricular ependymoma
Lateral ventricle (more common in children) and 4th ventricle
102
Typical location of intraventricular neurocytoma
Lateral ventricle (involving septum pellucidum)
103
Typical location of intraventricular mets
Lateral ventricle, ependyma, and choroid plexus
104
Typical imaging features of sellar/parasellar pituitary macroadenoma
Enlarged sella turcica, strong enhancement, sometimes hemorrhagic (apoplexy)
105
Typical imaging features of sellar/parasellar meningioma
Broad dural base with tail, enhancement along planum sphenoidale, hyperostosis
106
Typical imaging features of sellar/parasellar Schwannoma
T1-hypo and T2-hyperintense, strong enhancement (CN V most common)
107
Typical imaging features of sellar/parasellar chordoma
Bone destruction on CT, heterogenous signal and enhancement on MRI, respects dura
108
Typical imaging features of sellar/parasellar chondrosarcoma
Bone destruction and calcification on CT, T2-hyperintense on MRI
109
Typical imaging features of sellar/parasellar Rathke's cleft cyst
T1-hyperintense, smooth peripheral enhancement
110
Typical imaging features of sellar/parasellar dermoid
Hypodense on CT and T1-hyperintense on MRI
111
Typical imaging features of sellar/parasellar epidermoid
Isodense to CSF on CT and MRI T1 and T2 imaging, brighter than CSF on FLAIR and DWI
112
Typical imaging features of sellar/parasellar tuber cinerium
Grey matter isointense on T1 and T2 hamartoma hyperintense
113
Typical imaging features of sellar/parasellar optic glioma
Thickening of chiasm, spread along optic pathways
114
Typical imaging features of sellar/parasellar germ cell tumor
Located in midline, intense enhancement, often with pineal germinomas
115
Commonly calcified lesions
Oligodendrogliomas (90%), choroid plexus tumors (papillomas), ependymoma, central neurocytoma, meningioma, craniopharyngioma, teratoma, chordoma
116
Commonly hemorrhagic lesions
GBM, oligodendrogliomas, mets (melanoma, lung, breast)

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