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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
diuretics: acetazolamide
dietary changes, low salt, manage weight
serial LPs in some cases
+/- steroids


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

Autosomal Dominant
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

atypical 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


Where are brain tumours most commonly located? Features?

- posterior fossa accounts for 50% of brain tumours, most common in ages 1-8
- gait disturbances
- ocular nerve palsy #6
- good history and physical exam