Neurology Flashcards
(22 cards)
What are the identifying features of a TIA?
Unilateral symptoms that resolve within 24 - hours.
Frequent past symptoms that lead to ongoing insufficiency.
Sudden onset.
No permanent infarction.
What are the features of a SAH?
“Thunderclap headache”.
Caused by berry aneurysms.
Blood in CSF from lumbar puncture.
Requires surgery and or coagulants to treat.
What are the features of an intraparenchymal hematoma?
Hyperdense collection of blood on CT.
Caused by microaneurysm due to hypertension.
Focal neurological deficits, headache, vomiting, nausea.
Treat with surgery and coagulants.
What are the features of a subdural haematoma?
Cresent shape hyper density on CT.
Effects dura and arachnoid mater.
Rupture of bridge veins as a result of trauma (increased prevalence in those with increased fall risk).
Presents with coma / confusion, headache, nausea, vomiting and focal neurological deficits (anisocoria, hemiparesis, hyperreflexia, hypertonia).
Requires surgical removal.
What are the features of an epidural haematoma?
Biconvex lens shape as occurs between skull and duramater.
Rupture of middle meningeal artery due to temporal bone trauma.
Loss of consciousness with lucid intervals (level of brain compression is proportional to severity of symptoms).
Requires surgical removal.
What are the main symptoms of Multiple Sclerosis?
Upper motor neuron disease -> demyelination of corticospinal tract -> weakness, ataxia, horizontal nystagmus, high tendon reflex, foot clonus.
What causes ataxia during the Romburg test and intention tremor in multiple sclerosis?
Demyelination of the cerebellum.
What is the causes of the visual disturbances and optic disk pallor in multiple sclerosis?
Inflammation and demyelination of the optic nerve.
What are the exacerbation features of multiple sclerosis?
Chronic, progressive and relapsing.
Symptoms can persist for days and weeks and can worsen at certain times of the year. Lesions effect various parts of the CNS leading to varying distribution of symptoms.
What are the main features of amyotrophic lateral sclerosis (ALS)?
Progressive muscle weakness, atrophy, bulbar symptoms (difficulty speaking and swallowing).
Course is not relapsing and remitting.
What are the main features of myasthenia gravis?
Muscle weakness that worsens with exercise and improves with rest.
Which sets of muscles are effected in myasthenia gravis?
Ocular and bulbar muscles with no neurological symptoms.
Which anatomical structures are affected in ALS?
Degeneration of upper and lower motor neurons (progressive).
Specifically degeneration of pyramidal Betz cells in motor cortex, anterior horn cells of spinal cord and lower cranial motor nuclei of brain stem.
What are the histological features of ALS?
Replaced by gliosis.
Presence of Bunina bodies (eosinophilic inclusions) - hallmark.
What are the UMN symptoms of ALS?
Hyperreflexia, poor dexterity, incoordination and spasticity.
Bulbar UMN degeneration leads to disarthria and dysphagia (hypernasal speech, laryngospasms, cheek and tongue biting, sialorrhea, respiratory muscle weakness and general weakness), asymmetrical hand weakness, should girdle weakness and foot drop.
What are the LMN symptoms of ALS?
Muscle atrophy and fasciculations.
What is the progressive form of ALS?
Pick’s disease (frontotemporal dementia) which is characterised by apathy, disinhibition, changes in executive function and fluency.
What is syringomyelia?
Abnormal CSF circulation the forms a syrinx in cord parenchyma or central canal. Rapid initial deterioration that slows over time.
What are the symptoms of syringomyelia?
Pain, temperature insensitivity, muscle weakness, spasticity, paraesthesia, progressive scoliosis and Horner syndrome.
Tussive Chiari headaches (positive Valsalva manoeuvre).
Hoarseness dysphagia (traction of lower cranial nerve).
Visual disturbances (brainstem vestibulo - ocular connections).
Oto - neurological symptoms.
Tremors, dysmetria, ataxia, gait and balance issues.
Syncope and sleep disturbances.
What can trigger the symptoms of syringomyelia?
Sudden jolting of the head or prolonged bouts of coughing.
What is the most common mechanisms of basilar skull fractures?
Blunt force trauma involving temporal, occipital, sphenoid, ethmoid, orbital plate or frontal bones.
What are the signs of a basilar skull fracture?
Hemotympanum, CSF otorrhea, rhinorrhoea, battle sign (retroauricular ecchymosis) and raccoon eyes (periorbital ecchymosis).
