Neurology Flashcards
(26 cards)
What is ICH?
Bleeding into brain parenchyma from small arterioles often weakened by blood pressure
What are risk factors of ICH?
HTN, smoking, alcohol abuse,amyloidosis,wafarin
What will you find on the CT on ICH?
Fresh blood (hyperintense/bright white) on CT in a known vascular distribution
What are risk factors for a TIA?
Hypertension
AF
Diabetes
>55
Male
Smoker
family history
Prior TIA/stroke
Vasculitis
Name the typical sign of a TIA
sudden onset,
short duration (< 10 minutes)
weakness
numbness/tingling
speech problems
vision changes
dizziness
headache
What is the cause of a TIA?
temporary non-functioning brain because of a disruption causing lack of blood flow usually caused by an embolus: reversible and blood is restored in a short time
What investigations can be done to confirm a stroke?
Bloods: glucose, FBC, lipid , coagulation screen, ESR
CT brain
MRI brain
CT angiography and MR angiography
Carotid ultrasound
Echocardiography:
What is the acute management of a TIA?
1) 300mg aspirin
2) Referral for assessment within 24 hours by a stroke specialist clinician
Screen for atrial fibrillation and carotid stenosis*
3) confirmed TIA and not at high risk for haemorrhage
3A) dual antiplatelets for 21 days: i.e., continue aspirin at 75mg daily
3B) load additionally with clopidogrel 300mg stat, then 75mg daily
Initiate secondary prevention: lifestyle advice, statin, smoking cessation, hypertension and diabetes management
What are some red flags for headaches?
Headache that is new or unexpected in an individual patient
* Thunderclap headache (intense headache with abrupt or “explosive” onset)
* Headache with atypical aura (duration >1 hour, or including motor
weakness)
* Aura occurring for the first time in a patient during use of combined oral
contraceptives
* New onset headache in a patient older than 50 years
* New onset headache in a patient younger than 10 years
* Persistent morning headache with nausea
* Progressive headache, worsening over weeks or longer
* Headache associated with postural change
* New onset headache in a patient with a history of cancer
* New onset headache in a patient with a history of HIV infection.
what is cerebral venous thrombosis?
Thrombosis in the cerebral veins or ductal sinuses and causes obstruction to the drainage of the BBB and causes pressure.
Occlusion of dural sinus causes decreased cerebrospinal
fluid (CSF) absorption and elevated intracranial
pressure
What is are sign that are related to headaches caused by neoplasm?
Headache secondary to neoplasm characteristics:
* Progressive
* Worse in the morning and/or when lying
down
* Aggravated by Valsalva-like manœuvres
* Accompanied by nausea and/or vomiting
what are some risk factors of delirium?
Polypharmacy
dehydration
visual and hearing loss
sleeping depravation
age
medication
pre-existing dementia
electrolyte imbalance
serious illness
Infection
what are the symptoms of meningitis?
what are some sign of a sudural hemorrhage?
. Loss of Consciousness (LOC)
* Laceration or bruising on head
* Nausea / Vomiting
* Confusion
* Smell of EtOH
* Difficulty ambulating
What wouldbe the radioloigcal findings of a subdural hemorrage ?
Cresent shape bleed
midline shift
What are the radio logical signs of a epidural hemorrage?
Classic radiologic
finding is a “lens” or
“balloon” shaped
mass over surface of
brain.
* Usually has a mass
effect with midline
shift
what are symptoms of alcohol withdrawal?
shakiness
tremor
hallucinations
N+V
agitation
Anxiety
BP +HR elevated
what is used to treat active alcohol withdrawal symptoms?
Benzodiazapines
what is the opiate reversal medication?
Naloxone injection
What is MS?
It is an autoimmune disease that results in demyleination of the mylein sheath of the CNS
What investigations need to carried out to confirm?
MRI head
Neuro exam
What is the treatment for GBS?
2 weeks of elctorpharsesis
IVIG immunoglobulins
cardivascular monitioring
Analgesia(neuropathic pain) - Gabapetin
Whatis mythais gravis ?
Autoimmune disease- autoantibodies that attack acetyolcholine receptors
What are the symptoms of MG?
Ptosis
weakness(especially towards the end of the day
facial weakness
diplopia
proximal weakness of arms
