Flashcards in Neurology Deck (11):
When suspecting pseudotumour cerebri, what is management?
rule-out tumour and get imaging!
high opening pressure, remove enough to get to 150 mm H20
dietary changes, low salt, manage weight
serial LPs in some cases
Name the three elements of Cushing's triad
Irregular, ineffective respirations
How to manage cerebral edema in DKA?
decrease fluid rate by 1/3
hypertonic saline 5-10 mL/kg over 30 minutes
mannitol 0.5-1g/kg IV over 20 minutes, repeat if not better
CT to rule out alternate explanation, ie: thrombosis
What age does infantile spasms present?
Findings and treatment?
- 4-7 months: infantile spasms, developmental arrest, hypsarrhythmia
-meds: ACTH, prednisone
Describe features of juvenile myoclonic epilepsy
classic presentation with morning myoclonic sz
EEG generalized irregular spikes and polyspikes
generally well controlled on VPA but txt needs to be life-long
Describe features of an epidural hematoma
- blood btw skull and dura, elliptical or convex on CT
- classic lucid interval, rare in kids (<30%)
- arterial bleeding with middle meningeal artery
- 60-80% w/ ass' skull #
Describe subdural hematomas
- 5-10x more common than EDH
- concave or lens shaped on CT
- skull #s more rare
- underlying brain injury or cerebral contusion
- ** non accidental injury
-motor or sensory deficits, irritability, coma, seizures, herniation
- worse outcomes than EDH
Describe features of an acute confusional migraine
suddes onset of mental status changes: confusion, dysarthria, altered mental status
looks bad: stroke vs other
What are the mean ages of onset of migraines in boys and girls?
7 year old boy
11 year old girl
What are features of a classic migraine?
prodrome lasts up to 1 hr
throbbing, dull, unilateral
most common symptom: visual disturbance
lip, face, hand tingling, aphasia and weakness can occur
nausea and vomiting is common