Neuro Flashcards
(51 cards)
Define stroke
Sudden onset of focal neurological symptoms caused by interruption of the vascular supply to part of the brain, or intracerebral haemorrhage
Define epilepsy
Episodes of increased electrical activity within the brain leading to recurrent seizures
What is ataxia?
Loss of coordination of movements
What is rigidity?
Hypertonia characterised by increased resistance to passive stretch
Where is lumbar puncture performed and why?
What is the major contraindication and why?
Between L3 and L4 - spinal cord ends at L1
RICP - risk of tonsillar herniation
Where does an extradural haemorrhage occur?
Where does the blood come from?
Describe 2 radiological features
- Between the skull and the dura mater (or really between the periosteal and meningeal layers of dura mater)
- Arterial - usually middle meningeal artery
Why is extradural haemorrhage more likely to occur in younger patients?
In older people, the dural layers are more adhesive - less likely to split apart
Between which meningeal layers does a subdural haemorrhage occur?
Where does the blood come from?
- Meningeal layer of dura, and arachnoid mater
- Venous - bridging veins which drain from cerebrum into DVSs
What is it called if blood accumulates in the subarachnoid space?
What is the most likely cause?
What is the typical presenting feature?
- Subarachnoid haemorrhage
- Rupture of berry aneurysm
- Thunderclap headache
From which vessel does the anterior cerebral circulation originate?
What about the posterior circulation?
- ICAs
- Vertebral arteries
Outline the course of the ICAs in terms of landmarks and major branches
- Enters cranial cavity via carotid canal
- Passes through cavernous sinus - pierces dura - enters middle cranial fossa
- Gives off:
ophthalmic artery
posterior communicating artery
anterior cerebral artery - Continues as middle cerebral artery
Which areas are supplied by the anterior cerebral artery?
What would the symptoms be if it was occluded unilaterally?
Medial aspects of frontal and parietal lobes, and corpus collosum
Contralateral lower limb motor and sensory deficit
Which areas does the middle cerebral artery supply?
What would be the symptoms of unilateral occlusion?
- Lateral surfaces of cerebral hemispheres
- Occlusion causes contralateral sensory and motor deficit, particularly upper limb
- Contralateral hemianopia
Outline the course of the vertebral arteries in terms of landmarks and major branches
- Ascend in transverse foramina
- Enter via foramen magnum
- Give off
Anterior and posterior spinal arteries to SC
Posterior inferior cerebellar artery (PICA)
Which areas are supplied by the PICA?
What would happen in occlusion?
- Lateral medulla and cerebellum
- Contralateral loss of pain and temp
- Ipsilateral nystagmus/ataxia, Horner’s, dysphagia
What happens in occlusion of one of the vertebral arteries?
Usually anastomoses mean it’s fine
Which arteries converge to form the basilar artery?
Vertebral arteries
What does the basilar artery supply?
What would be the symptoms of occlusion?
Cerebellum and pons
Very serious - often coma, bilateral motor and sensory deficit, cerebellar signs, CN signs
How does the basilar artery terminate?
Bifurcates into posterior cerebral arteries
Which areas does the PCA supply?
Posterior hemispheres - posterior parietal and occiptal
Name 3 major vessels which could be occluded in a posterior circulation stoke
- Vertebral
- Basilar
- PCA
Which modalities are carried by the dorsal columns?
Fine (tactile) touch
Vibration
Proprioception
2-point discrimination
Where are the cell bodies of the 1st order neurones of the DCML?
Dorsal root ganglion
In which dorsal column do fibres from the upper body run?
Lower body?
Upper = lateral Lower = medial
