Qtr 3 Head and Neck Neurology (RAJA) Final
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What is the most common location of an Intraparenchymal hemorrhage?
Basal ganglia and thalamus 65%
What is the most common cause of cerebral hemorrhage?
What might a patient be diagnosed with if they present with sudden loss of consciousness, hemiplegia, convulsions, coma?
What type of hemorrhage occurs with a berry aneurysm?
What is the most common cause of a subarachnoid hemorrhage?
What is the symptomology of a subarachnoid hemorrhage?
- Nuchal rigidity
- Altered mental status
- Hydorcephalus (if blockage occurs)
What vein is most vulnerable to a subdural hemorrhage?
Superior Cortical Veins
What is the most common cause of a subdural hemorrhage?
What artery is commonly injured by a skull fracture and what type of hemorrhage does it cause?
- Middle meningeal artery
- Epidural Hemorrhage
What percent of Berry aneurysms occur within the carotid supply?
What type of aneurysm is most common in subacute bacterial endocarditis. It can spread infection into the subarachnoid space and cause leptomeneningitis and brain abscess?
Mycotic (Septic) Aneurysm
Where do most thrombosis cause damage in the brain?
Where does atherosclerosis most commonly appear first in the brain?
What percentage of adults have experienced a severe or disabling headache at least once?
Where is headache pain referred from the brain parenchyma?
None it does not produce pain
What type of headache is caused by muscle spasm, irritation of nasal and accessory structures, and eye disorders?
What type of headache causes extreme pain over the entire head?
Headache of meningitis
What type of headache is caused by a lumbar puncture?
Intracranial (low CSF pressure)
What is another name of a classical headache?
Migraine with aura
Are migraines unilateral or bilateral?
What type of headache presents with pain around one eye, tearing of eye, ptosis, stuffy nose, temporal pain?
What type of headache presents with an abrupt elevation in BP, Tachycardia, palpitations, sweating, tremor, sense of apprehension?
Headache due to Pheochromocytoma
where are neurofibrillary tangles found in alzheimer's disease?
Where are neuritic plaques found in alzheimer's disease?
What areas of the brain are atrophied in Pick's disease?
frontal and temporal lobes
In what disease would one see lewy bodies?
What are the parts of the corpus callosum?
- Rostrum:ant tip of canoe
What type of fibers synapse with the anterior lobe of the cerebellum?
- - Golgi tendon, muscle spindle
What type fibers synapse with the posterior lobe of the cerebellum?
- - Conscious movement
What type of fibers synapse with the folliculonodular lobe of the cerebellum?
- - balance and eye movement
What are the three layers of the cerebellum?
- Molecular layer (outer)
- Purkinge layer (primary ouput of cerebellum
- Granular (deep)
What are the fibers of the spinocerebellar and pontocerebellar tracts called?
What is caused by denaturing of proteins of the lens of the eye? (inability to accommodate)
What is hyperopia and what is the correction?
- It is farsightedness caused by focal point being behind the retina
- Convex lense
What is Myopia and what is the correction?
It is nearsightedness (focal point in front of retina)
What is the correction for astigmatism?
A rare neurologic disorder that impairs autonomic function and has parkinsonian symptoms
What is Multiple System Atrophy (shy-drager syndrome)
Atrophy of Caudate nucleus, frontal and temporal gyri
what is huntingtion's disease
What chromosome is the mutant gene for Huntington's disease found on?
Individuals having more than 40 repeating CAG sequences
what is huntington's disease
what is the probable mechanism of cell death in Huntington's disease?
Beta-hemolytic strep infection (rheumatic fever) is precursor. Typical onset of 5-15 yrs of age. 3-6 month duration of chorea?
Sydenham's Chorea (St. Vitus' Dance)
Mutation of long arm of chromosome 13. Symptoms: Tremor, diminished dexterity, unsteady gate, rigidity, Kayser-Fleischer ring?
- Wilsons Disease (hepatolenticular)
- Improper copper metabolism
- symptoms depend on deposit in lenticular nucleus
What movement is seen in globus pallidus lesion?
Athetosis (worm like hand eye neck)
Where is the lesion most likely in hemiballismus?
- Hemiballismus (violent movements)
Where is the lesion most likely in Chorea (quick jerky movments face and limbs)
How does dopamine affect the direct and indirect pathways respectively?
- Direct = excitatory
- Indirect = inhibitory
- overall = excitatory
CSF findings: Clouded, increased pressure, increase in neutrophils, increased protein, absence of sugar (eaten by bacteria), presence of organism
Suppurative meningitis (leptomeningitis)
What type of infection would you see CSF with: increase in lymphocytes and proteins, normal glucose?
Rapidly fatal dementia, pyramidal and extrapyramidal symptoms, severe atrophy of brain; intense astrocytosis in cerebral cortex, caudate, putamen.
What is the anatomical presentation of prion diseases?
Papovavirus that infects oligodendrocytes
Symptoms: hemiparesis, intellectual impairment, blindness, aphasia, death 3-6 months
Progressive multifocal leukoencephalopathy
Type of meningitis narrowing and obliteration of subarachnoid space due to trabeculae formation leading to hydrocephalus
Acute suppurative meningitis
Onset is insidious, anorexia and weightloss.
CSF contents: lymphocytes, increased protein, decreased glucose, tubercle bacilli
Associated with prior measles infection
multifocal areas of neuronal, destruction and gliosis fatal in 1-2 years.
Subacute sclerosing panencephalitis
What is the most common demylination disease?
What area if the spinal cord is most commonly affected by Multiple sclerosis?
CSF FINDINGS: increased lymphocytes and Ig levels, normal glucose levels, oligoclonal immunoglobulin bands
A patient presents with scanning speech, intention tremor, nystagmas what is your initial diagnosis?
Multiple Sclerosis (classic triad)
What viral infections are associated with acute disseminating encephalomyelitis
What disease involves demyelination of the peripheral nerves?
- Guillian -Barre syndrome
- (demyelination occurs inferior to superior)
CSF Findings: Albumino-cytoogic dissociation of CSF, greatly increased protein, slightly increased cell count
CN VII Upper motor neuron (ipsilateral or contralateral)
Where is the lesion: ipsilateral facial paralysis, loss of tast over anterior two thirds of tongue, hypercousis?
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