Almostadoctor topics Flashcards
(37 cards)
Define a cerebral aneurysm
A localised dilation of an artery within the brain
Give some risk factors for cerebral aneurysm development
Arteriosclerosis
HTN
Hereditary CT disorders
Septic emboli
Why are cerebral aneurysms called berry aneurysms?
Made up of many small sacs which bulge out from the vessel wall
What are the different surgical treatment options for cerebral aneurysms?
Clipping
Platinum coiling
Stenting
At what diameter are cerebral aneurysms operated on?
7mm or more
Define an ateriovenous malformation
An abnormal connection between arteries and veins which bypasses the capillary circulation
Where do AVMs usually occur?
Junction of cerebral arteries.
What investigation determines if the cerebral ANM is operable or not?
Arteriography
What are the treatment option for AVMs?
Watch and wait
Treat symptom only (epilepsy)
Radiotherapy (<3cm in size)
Surgery (larger, more superficial lesions) such as embolisation
What symptoms can AVMs cause?
88% are asymptomatic
Headache
Epilepsy
Specific symptoms can give an idea of the location
What can cause AVMs?
Hereditary Haemorrhagic telangiectasia (autosomal dominant)
Von Hippel-Lindau Disease
Describe Bulbar palsy
Lesion in the motor nuclei of the medulla which causes LMN signs in the facial, glossopharyngeal, vagus and hypoglossal nerve regions
What are the symptoms of bulbar palsy?
Tongue palsy Facial muscle palsy Swallowing palsy Flacid and fasciculating tongue Normal jaw jerk (CN5 intact) May have quiet, hoarse or nasal speech
What conditions can cause bulbar palsy?
MND Guillan-Barre Polio Syringobulbia Brainstem tumours Myasthenia gravis Myotonic dystrophy
Describe pseudobulbar palsy
Bilateral lesions of UMNs of muscles of regions for facial, vagus, glossopharyngeal and hypoglossal nerves. The lesion commonly occurs inthe corticobulbar tracts.
What are some symptoms of pseudobulbar palsy?
Spastic tongue (cannot protrude) "Donald Duck" speech Increased jaw jerk Reduced rate of blinking Emotional lability
What are some causes of pseudobulbar palsy?
Bilateral cerebral vascular accident affecting the internal capsule Multiple sclerosis Motor neuron disease Stroke Vascular dementia
Define Charcot Marie Tooth diesease
An inherited peripheral neuropathy, commonly autosomal dominant
What is the pathology of Charcot Marie Tooth disease?
Type 1 - gene mutations for myelin sheath growth
Type 2 - Mutations for mitochondria found in the nerves lead to improper nerve conduction
What are the symptoms of Charcot Marie Tooth disease?
- Progressive distal muscle weakness and wasting which causes gait changes
- Loss of reflexes and sensation
- Normal tone, slight reduction in power
- Champagne bottle legs appearance (peroneal muscle wasting)
- Pes cavus
- Hammer toe
What is the management of Charcot Marie Tooth disease?
Incurable Encourage activity Hydrotherapy Keep weigth low Genetic testing Surgery can reduce deformities e.g. clawed toes, pes cavus
Define encephalitis
Inflammation of the brain parenchyma usually due to a viral infection.
What are the most commonly implicated organisms for encephalitis?
Herpes simplex virus Rabies Measles Epstein Barr virus Poliovirus Coxsackievirus
What are the clinical features of encephalitis?
Headache Drowsiness Pyrexia Malaise Meningeal signs
