Neuro Flashcards
(27 cards)
GCS - M6 V5 E4
obeying commands; orientated; spontaneous eyes opening
GCS Motor
6 points
6 - obeying commands
5 - localising to pain
4 - withdrawing from pain
3 - flexing
2 - extending
1 - no response
GCS Voice
5 points
5 - orientated
4 - confused
3 - words
2 - sounds
1 - no response
GCS Eyes
4 points
4 - spontaneous opening
3 - open to voice
2 - open to pain
1 - no response
Lumbar puncture - bacterial meningitis
Mostly neutrophil
Cloudy
High protein
Low glucose (<1/2 plasma glucose)
Lumbar puncture - viral meningitis
mostly lymphocyte
clear
normal / raised protein
slightly low glucose
Lumbar puncture - tuberculous meningitis
Mostly lymphocyte
slightly cloudy
high protein
low glucose (<1/2 plasma glucose)
meningitis bacterial and tuberculous organisms
Explaining Big Hot Neck Stiffness
0-1mo: E.coli, Group B strep
1mo-6y: H. influenza, Neisseria meningitidis, Strep. pneumoniae
6y+: N. meningitidis, Strep. pneumoniae
60+/immunocompromised: N. meningitidis, Strep. pneumoniae, Listeria monocytogenes
meningitis viral organisms
enterovirus (coxsackievirus)
herpes simplex
cytomegalovirus
EBV
adenovirus
criteria for a CT head in 1h
GCS<13 at time of injury
GCS<15 2h post injury
depressed/open skull fracture
basal skull fracture signs
focal neurological deficit
post-traumatic seizures
>1 episode of vomiting
basal skull fracture signs
haemotypanum (blood in middle ear)
CSF rhinnorhea (from nose)
Battle sign (mastoid bruising)
panda eyes
LP contraindications
raised ICP signs
purpura fulminans (skin necrosis)
shock
seizure activity
local infection
respiratory distress
coagulopathy
raised ICP signs
headache
blurred vision
less alert, lethargy
vomiting
blurring of disc margins on fundoscopy
UMN / LMN signs
UMN = things go up (e.g. stroke, brain trauma)
hypertonia; hyperreflexia; spasticity; pathological reflexes; clonus; loss of fine hand movements
LMN = things go down (e.g. MND, peripheral neuropathy, spine cord injury)
flaccidity; hyporeflexia; wasting; hypotonia; fasiscuations
ataxic gait
unsteady, staggering gait
triad of symptoms in normal pressure hydrocephalus
urinary incontinence
dementia
gait abnormality
tardive dyskinesia
involuntary movements (grimacing, sticking tongue out, lip smacking)
(extrapyramidal SE -> of typical antipsychotics like haloperidol)
treat with tetrabenazine
acute dystonic reaction
torticollis (painful contractions of head/neck)
(extrapyramidal SE -> of typical antipsychotics like haloperidol)
treat with procyclidine / benztropine
akathisia
restless
(extrapyramidal SE -> of typical antipsychotics like haloperidol)
treat with propranolol
where’s the lesion? contralateral hemiparesis and sensory loss, lower extremity > upper
anterior cerebral artery
where’s the lesion? contralateral hemiparesis and sensory loss, lower extremity > upper, contralateral homonymous hemianopia, aphasia
middle cerebral artery (most common)
where’s the lesion? contralateral homonymous hemianopia with macular sparing, visual agnosia
posterior cerebral artery
where’s the lesion? Ipsilateral CN III palsy, contralateral weakness upper and lower extremity
Weber’s syndrome (branches of the posterior cerebral artery that supply the midbrain)
where’s the lesion? Ipsilateral: facial pain and temp loss, contralateral: limb/torso pain and temp loss, ataxia, nystagmus
posterior inferior cerebellar artery
