Term
| What is the term for the tertiary stage of syphyllis that has no treatment and leads to death? What is the name of the lesions that are present on the genitals? |
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Definition
-Neurosyphyllis
-Hunter's shanker |
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Term
| Does the brain have pain receptors? |
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Definition
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Term
| Mechanical traction, inflammation, or irritation of what 4 things cause headache? |
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Definition
| Blood vessels, meninges, scalp, skull |
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Term
| WHat causes migraine headaches? |
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Definition
| Over-reactive ability of neurons due to coffee, stress, menstrual cycle, etc. |
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Term
| At what age are migraines most prevalent? |
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Definition
| During the peak productive years (25-55) |
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Term
| Complicated migraines are accompanied by what? |
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Definition
| transient focal deficits (sensory deficit, weakness, visual loss, etc) |
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Term
| Basilar migraines can effect what autonomic functions? Where do they come from? |
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Definition
-breathing, HR, etc.
-Brainstem |
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Term
| What is the average range of duration for a cluster headache? |
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Definition
-30-90 minutes
-Every day for weeks, then vanish for months |
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Term
| What are some symptoms of cluster headaches? |
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Definition
-Extremely severe
-Around one eye
-Tearing
-Nasal congestion |
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Term
| What type of head ache is characterized by a steady, dull ache, associated with stress, bilateral, variable duration, and an unclear mechanism? |
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Definition
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Term
| What is another name for a headache caused by low cerebral spinal fluid pressure? |
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Definition
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Term
| What relieves a low CSF pressure headache? What makes it worse? |
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Definition
-relieved by lying down
-worse when upright |
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Term
| What does a manometer measure? |
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Definition
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Term
| A lumbar puncture provides direct access to what area? |
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Definition
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Term
| What is the lumbar cistern in direct communication with? |
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Definition
| The CSF in the ventricles |
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Term
| To avoid hitting the spinal cord in a lumbar puncture, the needle should be inserted below what vertebral level? |
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Definition
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Term
| Name 4 purposes of a lumbar puncture |
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Definition
-Obtain samples of CSF
-Measure opening pressure
-Therapeutically remove CSF in normal pressure hydrocephalus
-To introduce drugs or contrast material |
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Term
| Prior to a lumbar puncture what are three things one can due to evaluate for increased intracranial pressure? |
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Definition
-exame for papilledema
-CT scan
-MRI |
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Term
| What are three things that blood in the CSF could indicate? |
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Definition
-subarachnoid hemorrhage
-hemorrhagic herpes encephalitis
-a traumatic tap |
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Term
| How can you tell the difference between blood in the CSF due to a traumatic tap or a different pathology? |
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Definition
-A traumatic tap will have more blood in the first tube than in the last
-After centrifuging the supernatant will be clear with a traumatic tap, it will be xanthochromic if the blood has been in the CSF for several hours (bc of RBC lysis) |
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Term
| A post-ictal headache is oftentimes accompanied with what? |
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Definition
| Todd's paralysis- a brief period of paralysis that may be partial or complete, but on just one side of the body |
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Term
| What symptom sets meningitis apart from other less serious illnesses? |
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Definition
| Nuchal rigidity (stiff neck) |
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Term
| What are three ways to evaluate nuchal rigidity? |
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Definition
-can't touch chin to the chest
-Kernig's sign (flex hips and straighten knees--> pain in the hamstrings)
-Brudzinski's sign (neck flexion causes hips to flex) |
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Term
| Why are there symptoms in the legs (Kernig's sign and Brudzinski's sign) associated with meningitis? |
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Definition
| Lots of nerves from the leg muscles are coming to the lumbar plexus and meningitis is inflammation of the brain and spinal cord |
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Term
| What is temporal arteritis? |
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Definition
| Vasculitis affecting the temporal arteries AND arteries to the eyes |
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Term
| New headaches accompanied with abrupt onset of visual disturbances, Jaw claudication, polymyalgia rheumatica, and elevated ESR which normalizes with corticosteroids is symptomatic of what type of headache? |
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Definition
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Term
| What is polymyalgia rheumatica? |
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Definition
| aching and morning stiffness in the shoulders, hip girdles, neck, and torso in patients over 50 |
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Term
| What is the venous sinus? |
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Definition
| The drainage system in the head. All drain to the internal jugular vein |
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Term
| Prothrombotic conditions, oral contraceptives, pregnancy, malignancy, infection, head injury and mechanical precipitants are all possible causes of what? |
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Definition
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Term
| What are three types of head trauma? |
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Definition
-concussion
-injury to brain
-hemorrhage |
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Term
| What is the difference between anterograde and retrograde amnesia? |
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Definition
-Anterograde: difficulty remembering new facts and events occurring after lesion onset
-Retrograde: difficulty remembering events that occurred during the period of time immediately before lesion onset |
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Term
|
Definition
-Bruising of the surface of the brain beneath the point of impact. Inertia causes the brain the be flung against the side of the skull that was struck
-Head is suddenly stopped and the brain rushes forward |
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Term
|
Definition
-Bruising on the opposite side of the impact. Inertia of the brain causes it to be pulled away from the contralateral side of the skull
-Brain bounces off the primary surface and impacts the opposing side of the skull |
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Term
| Blows to the front of the head cause mainly _______ lesions, blows to the back of the head cause mainly _______ lesions. |
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Definition
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Term
| Is an epidural hematoma usually traumatic or spontaneous? Where does it occur? |
|
Definition
-traumatic
-in the tight potential space between the dura and the skull |
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Term
| Fracture of what bone is the usual cause of an epidural hematoma? What artery is often involved? |
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Definition
| Temporal bone, leading to rupture of the middle meningeal artery |
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Term
| Radiologically what does an epidural hematoma look like? What is the shape of the hematoma? |
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Definition
| Expanding hemorrhage peels the dura away from the skull, LENS SHAPED hematoma that does not spread across cranial sutures |
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Term
| What is the cynical series of events of an epidural hematoma from onset to death? |
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Definition
| Lucid interval (a few hours)-compression of brain- increased intracranial pressure- herniation- death |
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Term
| Is a subdural hematoma usually traumatic or spontaneous? Where does it occur? |
|
Definition
-Traumatic
-In the potential space between the dura and the loosely adherent arachnoid |
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Term
| What is the usual cause of a subdural hematoma? |
|
Definition
| rupture of bridging veins |
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|
Term
| Radiologically, what is the characteristic shape of a subdural hematoma? |
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Definition
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|
Term
| What is the usual treatment for a subdural hematoma? |
|
Definition
-surgical evacuation
-some resolve spontaneously |
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|
Term
| Where does a subarachnoid hemorrhage occur? |
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Definition
| In the CSF filled space between the arachnoid and the pia (contains major blood vessels of the brain) |
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Term
| Radiologically what does a subarachnoid hemorrhage look like? |
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Definition
| Blood tracks down into the sulci following the contours of the pia |
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Term
| What is the typical cause of a traumatic subarachnoid hemorrhage? |
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Definition
| Bleeding into CSF from damaged blood vessels, typically associated with other CNS damage |
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Term
| What are 2 typical causes of a spontaneous subarachnoid hemorrhage? |
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Definition
-ruptured aneurysm (80%)
-bleeding AVM (arteriovenous malformation) (15%) |
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Term
| Explosive catastrophic headache, meningeal irritation, focal neurologic deficits from vasospasm, and impaired alertness are common symptoms of what? |
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Definition
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Term
| Traumatic intracerebral hemorrhage is usually caused by ________ forces. Areas of bleeding occur in the _________ matter. |
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Definition
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|
Term
| What are two common causes of non traumatic intracerebral hemorrhage? |
|
Definition
-vascular malformations
-Hypertension |
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|
Term
| What are 3 causes of increased intracranial pressure? |
|
Definition
-Mass
-Hydrocephalus
-Pseudotumor cerebri (no mass) |
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|
Term
| What are the subjective signs of increased intracranial pressure? |
|
Definition
-headache
-impaired alertness
-nausea
-diplopia |
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|
Term
| What are 3 objective signs of increased intracranial pressure? |
|
Definition
-6th nerve (abducens) palsy
-papilledema
-increased pressure demonstrated by lumbar puncture |
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Term
| What classifies as a mass? What are 4 examples? |
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Definition
-anything abnormal that occupies volume within the cranial vault
-BEAN: Blood, Edema, Abscess, Neoplasm |
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Term
| What happens in an ischemic stroke? |
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Definition
| Clot stops blood supply to an area of the brain |
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Term
| What are the most common type of primary brain tumors? |
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Definition
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|
Term
| What is the most malignant form of glioma? (death within 1 year) |
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Definition
|
|
Term
| occur from the cerebellar stem cells, fills 4th ventricle, seen in children, vomiting is characteristic of which type of glioma? |
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Definition
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Term
| Occurring the deep white matter, slow-growing, causes seizures is characteristic of what type of glioma? |
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Definition
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Term
| What 5 types of cancer most often metastasizes to the brain |
|
Definition
| -LUNG, breast, kidney, GI tract, melanoma |
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Term
| Usually benign, slow growing, resectable, and often associated with breast CA is characteristic of what type of brain tumor? |
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Definition
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Term
| Endocrine disturbance and/or compressed optic chiasm is characteristic of what type of brain tumor? |
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Definition
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Term
| Schwannoma are especially prevalent in which cranial nerve? |
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Definition
| 8, auditory/vestibulocochlear nerve |
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Term
| Which type of brain tumor is from B lymphocytes, near ventricles, and often HIV related? |
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Definition
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Term
| What are the two most common types of brain tumors in adults? |
|
Definition
| Glioblastoma multiforme and metastases |
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|
Term
| Which two types of brain tumors are most common in children? |
|
Definition
-astrocytoma
-medulloblastoma |
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|
Term
| What are three ways brain tumors are clinically presented? |
|
Definition
-increased intracranial pressure
-seizures
-focal symptoms |
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Term
| Do malignant brain tumors usually spread out of the CNS? |
|
Definition
|
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Term
|
Definition
| Any distortion of brain geometry due to a mass |
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Term
| Mass effect can lead to what 3 things? |
|
Definition
1. increased intracranial pressure
2. Compression of adjacent areas
3. Herniation |
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|
Term
| Compression of the parenchyma can lead to what? |
|
Definition
| focal deficit or seizures |
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|
Term
| Compression of the ventricular system can lead to what? |
|
Definition
|
|
Term
| Compression of the BBB can lead to what? |
|
Definition
|
|
Term
| Compression of blood vessels can lead to what? |
|
Definition
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|
Term
| Since none of the contents of the intracranial space are compressible, mass effect can lead to contents __________ from one compartment into another |
|
Definition
|
|
Term
| What is a uncial herniation? |
|
Definition
| The medial temporal lobe (uncus) herniates downward through the tentorial notch |
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|
Term
| What is the uncial herniation clinical triad? |
|
Definition
-blown pupil from compression of CN III (oculomotor)
-Hemiplegia from compression of cerebral peduncles
-Diminished alertness from distortion of midbrain reticular formation |
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|
Term
| What is productive hydrocephalus often caused by? |
|
Definition
| Choroid plexus papilloma (benign neoplasm) |
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|
Term
| What is obstructive hydrocephalus usually caused by? |
|
Definition
| obstruction anywhere along the path of CSF flow |
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|
Term
| What is absorptive hydrocephalus usually caused by? |
|
Definition
| decreased absorption at the arachnoid granulations |
|
|
Term
| What are 4 symptoms of normal pressure hydrocephalus? |
|
Definition
(Absorptive hydrocephalus)
-unusual gait
-urinary incontinence
-dementia
-NO headache |
|
|
Term
| No increased intracranial pressure and no headache is characteristic of what type of hydrocephalus? |
|
Definition
|
|
Term
| Radiologically, what type of hydrocephalus is noncommunicating? |
|
Definition
-Obstructive
-Productive, absorptive, and compensatory are all communicating |
|
|
Term
| Name some characteristics presented with Pseudotumor cerebri |
|
Definition
-headache patient
-usually female
-overweight
-adolescent
-menstrual irregularities
-normal CT scan or MRI
-elevated CSF pressure measured on lumbar puncture, but NO space occupying structure |
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