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Tarascon 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

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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14
Q

Signs/symptoms of conductive aphasia

A

Difficulties with repetition

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15
Q

Lesion producing semantic aphasia

A

Atrophy of the anterior temporal lobe

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16
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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17
Q

Definition of prosopagnosia

A

Inability to recognize familar faces

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18
Q

Definition of anomia

A

Inability to name an object when presented

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19
Q

Definition of alexia

A

Inability to read

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20
Q

Definition of agnosia

A

Inability to recognize and identify objects or persons

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21
Q

Definition of agraphia

A

Inability to compose written language

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22
Q

Foster Kennedy syndrome signs/symptoms

A

Ipsilateral anosmia, ipsilateral scotoma with optic atrophy, contralateral papilledema

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23
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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24
Q

Lesion of the super nuclear gaze center produces…

A

Deviation to the affected side

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25
Function of the pontine gaze center
Directs eye movement to the ipsilateral side
26
Lesion of pontine gaze center produces...
Eye deviation to the contralateral side
27
Lesion of the MLF produces..
Loss of adduction of the ipsilateral eye, and nystagmus of the contralateral eye on abduction
28
Gradenigo syndrome
Otalgia (ophthalmic branch of trigeminal nerve), ipsilateral paralysis of abducens nerve, otitis media/mastoiditis (involving apex of petrous temporal bone)
29
Tolosa-Hunt syndrome
Granuloma of superior orbital fissure required for dx Painful, unilateral ophthalmoplegia, pupil sparring
30
Foix syndrome
Syndrome of superior orbital fissure Ophthalmoplegia, corneal anesthesia, proptosis, pupillary dilation
31
Tonic (Adie's pupil)
Postganglionic parasympathetic interruption (ciliary ganglion) Loss of direct or consensual light reflex, light-near dissociation
32
Marcus-Gunn pupil
Afferent pupillary defect Consensual reflex stronger than direct
33
Auditory agnosia: lesion and definition
Right temporal lobe lesion Inability to interpret sounds
34
Amusia: lesion and definition
Right temporal lobe lesion Inability to interpret music
35
Significance of lipid/lactate in MR spec
Inflammation, necrosis, anaerobic glycolysis
36
Significance of NAA in MR spec
Neuronal viability
37
Significance of creatine in MR spec
Energy metabolism, useful reference peak as generally stable
38
Significance of glutamine/glumatate in MR spec
Neuronal damage (astrocytes), neurotransmitters
39
Significance of choline in MR spec
Membrane turnover (phospholipid synthesis)
40
Neurogenic shock
Hypotension secondary to interruption of sympathetics (loss of vascular tone), bradycardia from unopposed parasympathetics, relative hypovolemia due to venous pooling from decreased muscle tone, and hypothermia
41
Treatment of hypotension in neurogenic shock
Dopamine ggt (epi can exacerbate bradycardia)
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
Anterior spinal artery syndrome
Flaccid transitioning to spastic paralysis, hyperreflexia, loss of pain and temperature, intact vibratory and proprioception (posterior column function preserved)
45
Atlanto-dental interval (ADI)
Distance on lateral XR between back of C1 anterior tubercle (atlas) to the anterior aspect of the odontoid
46
Normal ADI
Adult is up to 3 mm, in children is up to 5 mm
47
Chamberlain's line
Posterior aspect of hard palate to posterior edge of foramen magnum (opisthion) If the dens > 6 mm above this line, consistent with vertical translocation
48
McGregor's line
Dorsal edge of the hard palate to the caudal occiput If dens > 4.5 mm, consistent with invagination
49
McRae's line
Opening of the foramen magnum Tip of dens should not be above this line
50
Power's ratio
Ratio of BC (distance from the basion to the midcervical portion of the posterior laminar line of the atlas) over OA (opisthion to midcervical portion of posterior surface of anterior ring of atlas) Anterior subluxation present if ratio > 1
51
Rule of Spence
On odontoid view XR, if sum of C1 lateral mass overhang on C2 is 7 mm, then this suggests transverse ligament instability
52
Facet orientation in cervical spine
Posteromedial
53
Facet orientation in upper thoracic spine
Coronal (resistance to anterior translation but not rotation)
54
Facet orientation in lower thoracic spine
Sagittal (less resistance to anterior translation)
55
Definition of teardrop fracture
Flexion-compression injury Vertebral body with > 50% original height Injury to PLL Unstable
56
Definition of wedge fracture
Fracture of the anterior column Stable if
57
Definition of clay-shovelers fracture
C7 spinous process fracture
58
Definition of burst fracture
Fracture of the anterior and middle columns from axial compression injury
59
Definition of Chance fracture
A flexion-distraction fracture through all 3 columns (including disruption of PLL, shearing of pedicle/vertebral body)
60
Definition of Schmorl's nodes
Herniation of the nucleus pulposus into the end plate Associated with endplate fracture
61
Definition of AA impaction (basilar invagination)
Subluxation of the dens through the foramen magnum leading to brainstem compression
62
Symptoms of basilar invagination
Myelopathy, HA, nystagmus, cranial neuropathies
63
Definition of lateral recess syndrome
Compression of nerve root in lateral recess between hypertrophied superior articular facet, pedicle, and inferior vertebral body
64
Extradural spinal tumors that are metastatic and destructive
Lymphoma, lung, breast, prostate
65
Extradural spinal tumors that are metastatic and osteoblastic
Prostate, breast
66
Characteristics of eosinophilic granulomas
Lytic lesion without surrounding sclerosis Classic cause of single collapsed vertebral body in pediatric patients, if no evidence of trauma Hyperintense on T2, enhances with contrast
67
Type 1 spinal AVM
Dural AV fistula Extramedullary, no nidus, low flow, simple dorsal venous drainage, lower thoracic/conus Presents with progressive neurologic deficits, secondary to venous congestion
68
Type 2 spinal AVM
Glomus Intramedullary, may present with hemorrhage, high flow, cervicothoracic junction
69
Type 3 spinal AVM
Juvenile Intra- and extradural but with intramedullary nidus, high flow, cervical/upper thoracic Marked propensity to bleed, multiple feeders over multiple segments, present with progressive neurological deficit
70
Type 4 spinal AVM
Perimedullary dural AV fistula with extramedullary nidus
71
Foix-Alajouanine syndrome
Thrombosis of spinal cord AVM Necrosis of gray>white matter Presents with subacute myelopathy
72
Definition of transverse myelitis
Sudden onset of autoimmune demyelination or inflammation across one spinal cord segment
73
Etiology of transverse myelitis
Lupus, postinfectious viral or bacterial, vaccinations, Bechet's syndrome, MS
74
Presentation of transverse myelitis
Sensory level, weakness, pain, paralysis, urinary incontinence
75
Treatment of transverse myelitis
Steroids
76
Klippel-Feil syndrome
Congenital fusion of two or more cervical vertebrae (usually involves C2-3)
77
Common location for mycotic aneurysms
MCA distribution
78
More common location for fusiform aneurysms
Vertebrobasilar system
79
Possible localizing signs for ACOM aneurysms
BLE weakness, numbness
80
Possible localizing signs for MCA bifurcation aneurysms
Contralateral weakness, aphasia (left), or hemi-neglect (right)
81
Possible localizing sings for basilar tip aneurysms
Vertical ophthalmoplegia
82
Possible localizing signs for vertebral-PICA junction aneurysms
Wallenberg's, vertigo, Horner's, sensory deficits
83
Possible localizing signs for ICA-PCOM junction aneurysms
Ipsilateral CN III palsy (pupil involving)
84
Signs/symptoms of venous sinus thrombosis
HA, nausea, vomiting, seizures, hemiparesis, CN dysfunction, papilledema, blurred vision, AMS
85
Diagnosis of venous sinus thrombosis
CT ("delta sign" looking at sagittal sinus)
86
Treatment of venous sinus thrombosis
Heparin anticoagulation, +- thrombolytics, AVOID steroids, control BP, monitor ICP
87
Cavernous hemangioma (AKA cavernous malformation, cavernoma)
Low flow, low pressure vascular malformations
88
Presentation of cavernomas
Seizures (60%), progressive neuro deficit (50%), and hemorrhage (20%), or hydrocephalus
89
Location of cavernomas
Mostly supratentorial
90
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 ```
91
Pathology of cavernomas
Irregular vasculature with no intervening brain "popcorn or mulberry" apperance
92
Pathophysiology of moyamoya
Progressive occlusion of one or both supraclinoid ICAs, M1s, A1s, (and rarely P1 PCAs) resulting in a "puff of smoke" appearance of dilated capillary lenticulostriate collateral vessels
93
Presentation of amyloid angiopathy
Presents as lobar intraparenchymal hemorrhage
94
Common location for intraparenchymal hemorrhages in amyloid angiopathy
Frontoparietal, corticomedullary junction
95
Pathology of amyloid angiopathy
Deposition of beta amyloid in the media and adventitia of small and mid-sized arteries
96
Osler-Weber-Rendu disease
AVMs of lung, liver, brain, and spine
97
Symptoms/signs of Osler-Weber-Rendu disease
In addition to AVMs, patients develop telangiectasias of skin, mucosa (epistaxis)
98
Wyburn-Mason syndrome
Multiple intracranial AVMs along the visual pathways (including optic tract, midbrain), AVMs (including retina), and facial cutaneous vascular nevi
99
Signs/symptoms of Wyburn-Mason syndrome
Optic nerve atrophy, seizures, strokes, SAH
100
Blue rubber bleb nevus syndrome
Vascular malformations of skin, GI tract, CNS (hemangiomas, venous angiomas, sinus pericrani)
101
Signs/symptoms of blue rubber bleb nevus syndrome
Anemia from GI bleeds, nevi on arms/trunk, palms, fractures (from bone hemangiomas)
102
Definition of Wallerian degeneration
Process of axonal degeneration distal to the site of injury or transection; occurs in both the CNS and PNS
103
Findings of Sunderland nerve injury grade 1 (neuropraxia)
Localized myelin damage (compression)
104
Findings of Sunderland nerve injury grade 2 (axonotmesis)
Loss of axonal continuity; endo-, peri-, and epineurium intact
105
Findings of Sunderland nerve injury grade 3
Axonal and endoneurial continuity lost
106
Findings of Sunderland nerve injury grade 4
Axonal, endoneurial, perineurial continuity lost
107
Findings of Sunderland nerve injury grade 5 (neurotmesis)
Complete nerve lesion
108
Symptoms of occipital neuralgia
HA involving the posterior occiput in the greater or lesser occipital nerve distribution
109
Contents of carpal tunnel
Flexor digitorum superficialis and profundus tendons, flexor pollicis longus tendon, and the median nerve
110
Location of ligament of Struthers and what nerve does it compress?
Located between the distal humerus and medial epicondyle Entrapment of the median nerve here leads to distal median nerve symptoms plus decreased pronation, wrist/digit flexion, thumb flexion, abduction, and opposition
111
Wartenburg's sign seen in ulnar nerve entrapment
5th finger has position of abduction secondary to unopposed ulnar insertion of extensor digiti quinti
112
Duchenne's sign seen in ulnar nerve entrapment
Clawing of medial 2 digits
113
Froment's sign seen in ulnar nerve entrapment
On attempt to adduct the joint, will flex the finger
114
Classic triad of symptoms in Parkinson's disease
Resting tremor (4-8 Hz/second), cogwheel rigitidy, and bradykinesia

NS (25 decks)

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