Flashcards in Neurology Deck (21):
What are the pathological findings of IgG4 related hypertrophic pachymeningitis?
What are the treatments of IgG4 related hypertrophic pachymeningitis?
Immunosuppression (azathioprine / methotrexate)
What is the treatment of reversible cerebral vasoconstriction syndrome?
Can give Verapamil (but no evidence) and then repeat the CT-A in 3 months to ensure it has resolved
What is the presentation of reversible cerebral vasoconstriction syndrome?
Cluster of severe headaches within a month
May have convexity SAH
Normal CT initially but then the vessels go into spasm
Triggered by coughing / orgasm / physical exertion / peripartum / cocaine use / SSRIs / Triptams
Can RCVS patients develop infarcts?
Yes , usually in the watershed areas
Also they can develop PRES
What parasite causes
Taenia solium via human fecal transmission;
Pig is the intermediate host and if the pig is eaten causes GI tape worm!
What is the treatment for neurocystercicosis?
Mainly albendazole & praziquantel +/- steroids
Shunt if hydrocephalus or if significant mass effect
MRI features of IIH?
Normal ventricle size
Tortuous optic nerves
Flattening of the optic nerve at the back of the orbit
Stenosis of the transverse sinuses
Management options for IIH?
Acetazolamide and methylprednisolone
Shunt - VP or LP
Optic nerve fenestration
Transverse sinus stenting
What is the differential diagnosis of meningeal hypertrophy?
Infectious - TB / fungal meningitis
Inflammatory - Neurosarcoidosis / IgG4 related hypertrophic pachymeningitis
Neoplastic - Leptomeningeal metastatic disease / enplaque meningioma
Best test for sarcoidosis?
HR CT chest for bihilar lymphadenopathy
What lesions occur with IgG4 disease?
What is the DD for IgG4 related disease?
Peripheral nerve sheath tumour
Young female with recurrent thunderclap headache and small amounts of convexity SAH blood?
RCVS - recurrent cerebral vasoreactive syndrome
Need to rule out vasculitis!
Treatment of Neurocysticercosis?
Albendazole & Praziquantel
What part of vision is affected in BIH?
What is first line treatment for IIH?
5% weight loss can cure IIH
Surgical Treatments for IIH?
Venous sinus stenting
What is the diagnosis with open ring contrast lesion?
Has hypointense ring (which is hypodense on CT)
Fitting patient with low BM. How do you treat the BM?
Thiamine and Glucose!