Random Neuro

Question 1

Cerebral perfusion is primarily driven by

Answer 1

PCO2

Question 2

Use of therapeutic hyperventilation (decreased PCO2)

Answer 2

Helps decrease ICP in cases of acute cerebral edema (stroke, trauma) via decreasing cerebral perfusion

Question 3

Rupture of middle meningeal artery (branch of maxillary artery)

Answer 3

Epidural hematoma

Question 4

Rupture of bridging veins

Answer 4

Subdural hematoma

Question 5

Rupture of aneurysm (such as berry)

Answer 5

Subarachnoid hemorrhage

Question 6

Caused by systemic hypertension

Answer 6

Intraparenchymal (hypertensive) hemorrhage w/in brain parenchyma

Question 7

Often due to fracture of TEMPORAL bone

Answer 7

Epidural hematoma

Question 8

Often seen in elderly, alcoholics, blunt trauma, shaken baby syndrome

Answer 8

Subdural hematoma

Question 9

WHOML

Answer 9

SAH

Question 10

Has a lucid interval “talk and die”

Answer 10

Epidural hematoma

Question 11

Slow venous bleed = less pressure = hematoma develops over time

Answer 11

Subdural hematoma

Question 12

Rapid time course

Answer 12

SAH

Question 13

Rapid expansion under systemic arterial pressure –> Compression of brain –> transtentorial herniation –> CN III palsy (down and out, fixed and dilated pupil); HA, vomiting, seizures

Answer 13

Epidural hematoma

Question 14

Blood between dura and skull

Answer 14

Epidural hematoma

Question 15

Blood between dura and arachnoid

Answer 15

Subdural hematoma

Question 16

Blood in subarachnoid space

Answer 16

Subarachnoid hemorrhage

Question 17

Typically occurs in basal ganglia and internal capsule

Answer 17

Intraparenchymal (hypertensive) hemorrhage

Question 18

MCC of SAH

Answer 18

trauma, ruptured aneurysm, ruptured AV malformation

Question 19

CT - biconves (lentiform) lens shaped that does not cross suture lines

Answer 19

Epidural hematoma

Question 20

CT - Crescent-shaped that crosses suture lines

Answer 20

Subdural hematoma

Question 21

Bloody or yello (xanthochromic - bilirubin) spinal tap

Answer 21

Subarachnoid hemorrhage

Question 22

Irreversible brain damage begins after how many minutes of hypoxia

Answer 22

5 minutes

Question 23

Areas most susceptible to ischemic damage

Answer 23

hippocampus, neocortex, cerebellum, watershed areas

Question 24

Bright stroke on MRI

Answer 24

for 10 days

Question 25

Dark stroke on noncontrast CT in

Answer 25

~24 hours

Question 26

Bright areas on noncontrast CT indicate

Answer 26

HEMORRHAGE (tPA contraindicated)

Question 27

Causes of thrombotic/ischemia stronke

Answer 27

a. fib, carotid dissection. patent foramen ovale, endocarditis

Question 28

When can you give tPA

Answer 28

Only if pt. presents w/in 3 hours of onset, no major risk of hemorrhage: active bleeding, hx intracranial bleeding, recent surgery, severe HTN

Question 29

Layers going through for LP @ L4/5

Answer 29

1. Skin 2. Superficial space 3. Ligamnets (supraspinous, linterspinous, ligamentum flavum) 4. Epidural space 5. Dural mater 6. Subdral space 7. Arachnoid membrane *8. Subarachnoid space - GET CSF HERE

Question 30

Flow of CSF

Answer 30

lateral ventricle --> R/L intraventricular foramina of Monro --> 3rd ventricle --> cerebral aqueduct of Sylvius --> 4th ventricle --> Foramina of Luschka and Foramne of Magendie --> Subarachnoid space

Question 31

Decreased CSF absoprtion by arachnoid granulations --> increased ICP, papilledema, herniattion

Answer 31

Communicating hydrocephalus

Question 32

Increased subarachnoid space volume, no increase in CSF, expantion of ventricles distorts fibers of corona radiatia --> urinary incontinence, ataxia, cognitive dysfunction (sometimes reversible)

Answer 32

Normal pressure hydrocephalus

Question 33

Appearance of increased CSF in atrophy (Alzheimer's, advanced HIV, Pick's disease) ICP normal - looks like ventricles are enlarged

Answer 33

Hydrocephalus ex vacuo

Question 34

Caused by a structural blockage of CSF circulation within the ventricular system (e.g. stenosis of aqueduct of sylvius) --> HA, papilladema, uncal herniation --> CN III palsy, increased ICP, death

Answer 34

Noncommunicating hydrocephalus