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Neuro Path 470

QuestionAnswer
Uncus medial temporal lobe
herniations can compress anterior cerebral artery
ACA motor cortex - lower limb sensory cortex - lower limb contralateral paralysis - lower limb contralateral loss of sensation - lower limb
lateral striate artery striatum, internal capsule
lateral striate artery contralateral hemiparesis/hemiplegia
common location of lacunar infarcts, secondary to unmanaged hypertension lateral striate artery
MCA motor cortex - upper limb and face sensory cortex - upper limb and face Wernicke's area, Broca's area
symptoms of MCA contralateral paralysis - upper limb and face contralateral loss of sensation - upper limb and face hemineglect if lesion affects nondominant side (usually right side)
lateral corticospinal tract medial lemniscus caudal medulla - hypoglossal nerve contralateral hemiparesis - lower limbs decreased contralateral proprioception ipsilateral hypoglossal dysfunction (tongue deviates ipsillaterally)
lateral medulla - vestibular nuclei, lateral spinothalamic tract, spinal trigeminal nucleus, nucleus ambiguus, sympathetic fibers inferior cerebellar peduncle PICA
vomiting, vertigo, nystagmus limbs/face - decreased pain, temperature, sensation dysphagia, hoarseness, decreased gag reflex ipsilateral horner's syndrome, ataxia, dysmetria PICA - lateral medullary Wallenberg's syndrome
common site of saccular (berry) aneurysm -> impingement on cranial nerves AComm and PComm
lesions are typically aneurysms, not strokes AComm and PComm
CN3 palsy - eye down and out PComm
visual field defects AComm
what helps decreased ICP in cases of acute cerebral edema (stroke, trauma)? therapeutic hyperventilation (decreased PCO2)
normal pressure hydrocephalus does not result in increased subarachnoid space volume wet wobbly wacky dementia, ataxia, and urinary incontinence
causes of intraparenchymal (hypertensive) hemorrhage systemic HTN amyloid angiopathy vasculitis neoplasm
where does intraprenchymal hemorrhage occur? basal ganglia internal capsule
CN3 palsy, rapid expansion under systemic arterial pressure -> transtentorial herniation epidural hematoma
secondary to fracture of temporal bone epidural hematoma
rupture of middle meningeal artery epidural hematoma
uncal herniation -> stretching of CN3 (innervates levator palpebrae) ipsilateral dilated pupil/ptosis
compression of ipsilateral PCA contralateral homonymous hemianopsia with macular sparing
compression of contralateral crus cerebri (kernohan's notch) ipsilateral paresis
caudal displacement of brain stem duret hemorrhages - paramedian artery rupture
ring enhancing lesion metastasis (lung > breast > melanoma > kidney > GI), abscesses, toxoplasmosis, primary CNS lymphoma (a/w AIDS, EBV)
uniformly enhancing lesion metastatic lymphoma (often B cell non-hodkin's) meningioma, metastases (usually ring enhancing)
heterogenously enhancing lesion GBM
where do adult brain tumors usually present gray-white junction
port wine stain, V1 distribution sturge weber
ipsilateral leptomeningeal angioma sturge weber
pheochromocytoma neurocutaneous disorder sturge weber
glaucoma, seizures, hemiparesis, MR sturge weber
sporadic occurance sturge weber
positional testing -> delayed horizontal nystagmus peripheral vertigo - inner ear etiology
positional testing -> immediated nystagmus in any direction; may change directions central vertigo - brain stem or cerebellar lesion (i.e. vestibular nuclei, posterior fossa tumor)
malignant but radiosensitive tumor medulloblastoma
abnormal Rinne test ( bone > air) conductive hearing loss
normal Rinne test sensorineural (air>bone)
weber test localizes to affected ear conductive
weber test localizes to unaffected ear sensorineural
treatment for trigeminal neuralgia carbamazepine
most common origination of partial seizure medial temporal lobe
preceded by seizure aura partial seizures
simple partial seizure consciousness intact - motor, sensory, autonomi, psychic
complex partial seizure impaired consciousness
generalized seixures diffuse seizure
absence blank stare - petit mal, 3 Hz, no postictal confusion
myoclonic quick repetitive jerks
tonic clonic (grand mal) - alternating stiffening and movement
tonic stiffening
atonic "drop" seizures (falls to floor; commonly mistaken for fainting
tonic clonic seizures tx phenytoin, carbamazepine, valproate
simple partial seizure carbamazepine
complex partial seizure carbamazepine
status epilepticus seizure phenytoin
absence seizure ethosuximide
acute status epilepticus benzodiazepine (lorazepam or diazepam)
myoclonic seizure valproate
seizures of eclampsia first line = MgSO4 second = benzodiazepine
peripheral neuropathy or bipolar disorder gabapentin
trigeminal neuralgia carbamazepine
blocks thalamic T type Ca channels ethosuximide
what is contraindicated in porphyrias? barbiturates
Created by: ilovemusic007
 

 



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