neuro 21 Flashcards
(29 cards)
Kernig’s sign
pain upon attempted passive extension at the knee when the hip is flexed
Brudzinski’s sign
involuntary flexion of the hip when the neck is flexed
treatment of brain abscess
prolonged courses of IV antibiotics are mainstay;
why is LP contraindicated in spinal epidural abscess before you know the exact location?
possibility of seeding the subarachnoid space with bacteria using the spinal needle
treatment of epidural abscess
prolonged IV antibiotics
how does TB meningitis differ from normal bacterial meningitis?
TB has a predilection for the basal meninges and thus can present with CN palsies in addition to usual features of meningitis; also TB is more subacute or chronic, with prolonged prodrome
basal meningitis
more commonly leads to hydrocephalus or brain infarcts from inflamm affecting the cerebral vessels
how is CSF in TB meningitis different from bacterial?
leukocytosis w lymphocytic predominence not PMNs; CSF glucose is even lower
tuberculoma
mass lesion caused by TB
Pott disease
TB of the spine
when do neuro symptoms of lyme disease appear?
several weeks after the bite
neuro findings in lyme disease
headache, stiff neck, myalgias, CN palsies (most commonly facial nerve), polyradiculopathy (with pain), polyneuropathy, enecephalopathy
CSF in lyme disease
lymphocytic pleocytosis wth elevated protein and normal glucose
MRI of the brain in lyme encephalopathy
patchy foci of signal change in the white matter
treatment of neuro lyme
if negative CSF, treat with oral antibiotics; more disem neuro infection requres IV antibiotics
viral meningitis is commonly caused by what organisms?
enteroviruses, such as Coxsackie virus, or arbovirus such as West Nile virus
HSV1 encephalitis differs from general encephalitis how?
HSV has a predilection for the base of the brain, specifically the medial temporal lobes and orbitofrontal regions
CSF in HSV1 encephalitis
elevated RBC count in addition to leukocytosis
treatment for HSV1 encephalitis
prolonged IV course of acyclovir
most common form of fungal meningitis
crypto
CSF profile in crypto meningitis
lymphocytic predominance of white blood cells, elevated protein, and low glucose; this pattern is seen with all fungal meningitis
imaging studies of toxo of the brain
multiple rign-enhancing lesions in the basal gang or at the gray matter-white matter junction
neurocystcercosis
infection caused by the pork tape work Taenia solium
where is neurocysticercosis endemic?
cental and south america; so commonly seen in immigrant populations in the US
