Neurology Flashcards
CSF opening pressure:
Causes for
- high
- low
Low: CSF leak, Recent LP
High: Meningitis, Tumour, Intracranial haemorrhage, benign intracranial HTN
CSF appearance and cause:
- Clear
- Cloudy / Purulent
- Bloody
Normal
Meningitis (TB V cloudy)
Traumatic tap (due to punctured vessel) or SAH - Lab testing for xanthochromia helps distinguish traumatic tap and SAH
WCC in CSF
Neutrophils in bacterial
Lymphocytes in viral and TB
Raised also in inflammatory diseases and cancer
Further testing of CSF if infection suspected
Gram staining, Ziehl-Neelsen (TB), culture, PCR (Bacterial/Viral DNA)
More specialist testing is needed if unusual organism is suspected (Syphilis, Cryptococcus, HIV)
Protein in CSF
- Normal range
- Causes of elevation (not diagnosis can not be made on protein value alone)
0.15 - 0.45g/L
Meningitis, Neoplasia, Abscess, Haemorrhage, Guillain-Barre, MS
CSF Glucose
- How to interpret
- Normal
- Causes for abnormal levels
Compare to blood glucose
Should be 40-60% BG
Bacterial/fungal/TB infections
Whats is xanthochromia and when seen in CSF
Yellow discolouration of CSF due to bilirubin presence
Jaundice, SAH (blood breaks down to bilirubin in 12 hrs)
Oligocolnal band in CSF
This shows immunoglobulins in the CSF
Characteristic of MS
Most common reason to do nerve conduction studies
Carpal tunnel most common
Reason to do an EEG
Epilepsy
Creutzfeldt-Jakob
Quick test for neurological status
AVPU
Alert
respond to Voice
respond to Pain
Unresponsive
GCS
EVM 456
GCS Eyes
Spontaneously open
To speech
To pain
None
GCS Verbal
Oriented Confused Inappropriate words Incomprehensible sounds None
GCS Motor
Obey commands Localise to pain Flexion withdrawal Abnormal flexion Extension to pain None
