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Neuro Path 470
| Question | Answer |
|---|---|
| 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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