Neuro Flashcards
What type of bleed do you suspect if a CT head shows a star shaped lesion?
Subarachnoid haemorrhage
What type of bleed do you suspect if a CT head shows a lentiform shaped accumulation of blood?
Extradural haematoma
What type of bleed do you suspect if a CT head shows a crescent shaped accumulation of blood?
Subdural haematoma
What is the triad of symptoms in Horner’s syndrome? What causes Horners?
- Ptosis, miosis, anhidrosis.
- Caused by interruption of the ipsilateral sympathetic pathway e.g. by carotid artery dissection/cavernous sinus lesion
A patient presents with a history suggestive of subarachnoid haemorrhage, the CT has been done and is found to be -ve. What investigation do you want to do next and what are you looking for?
An LP looking for xanthochromia (yellow CSF due to bilirubin content)
> must be performed to exclude SAH if the CT is negative. LP should be delayed for 12 hours after headache onset as false negative results can occur before that time. It remains reliable for up to 12 days (12 hour to 12 day rule).
What drug is used to manage people with a confirmed SAH?
Nimodipine (a calcium-channel blocker that reduces spasm of the ruptured cerebral artery, thus preventing a stroke)
Patients with migraines are advised to take acute abortive treatment as soon as they feel a migraine coming on. Such treatment includes drugs such as such as triptans (5HT1-agonists). Give an example of such a drug.
Sumatriptan
What signs are positive in meningism
Kernig’s sign and Brudzinski’s signs
What is the most common type of brain tumour in children?
A medulloblastoma in the cerebellum
When performing an LP, what is a normal opening pressure? What would you expect opening pressure to be in meningitis?
Normal: 7-18cm of CSF
Meningitis: May be >40; typically 14-30cm
You carry out a lumbar puncture. What findings in terms of the leucocytes and glucose in the CSF, would you expect in:
a) Bacterial meningitis
b) Viral meningitis
a) Increased neutrophils; decreased glucose
b) Increased lymphocytes; normal glucose
What level do you carry out an LP?
L3/4
What can be found in LP of someone with MS?
Oligoclonal bands
How do you know if a seizure is partial or general?
If the seizure begins with focal features, it is a partial seizure - regardless of how rapidly it then generalizes. It becomes known as a secondary generalized seizure (or partial seizure with secondary generalization)
What drugs are first line for general tonic clonic seizures?
Sodium valproate or lamotrigine
