Head pathologies pt 2 :)

Which of these tumors can metastasize to the CNS?

Which of these is not a common CNS tumor in children?

Meninngioma is more common in women

Primary Brain Trauma [blank_start]Car[blank_end] crashes Falls [blank_start]Bullet[blank_end] wounds Secondary Brain Trauma Brain [blank_start]bleeds[blank_end] [blank_start]Swelling[blank_end] Meningitis

Which of these are potential complications of meningitis?

What are the contraindications to lumbar puncture?

What is of clinical relevance regarding meningitis?

Treat all suspected meningitis with: IM [blank_start]benzylpenicillin[blank_end] in community IV [blank_start]ceftriaxone[blank_end]/ cefotaxime If meningococcal meningitis, close contacts give [blank_start]rifampicin[blank_end] prophylaxis

If it's a meningitis medical emergency, treatment order:

Alzheimer's disease is inevitable in Down's syndrome

What is not a type of dementia?

In [blank_start]Lewy[blank_end] [blank_start]Body[blank_end] dementia, the patient presents with fluctuating cognitive impairment, detailed visual hallucinations, and later [blank_start]parkinsonism[blank_end]. Histology is characterized by [blank_start]Lewy[blank_end] [blank_start]bodies[blank_end] in brainstem and neocortex.

[blank_start]Frontotemporal[blank_end] dementia is when there is frontal and temporal atrophy without Alzheimer histology. Symptoms: [blank_start]Behavioral[blank_end] and personality change preservation of [blank_start]episodic[blank_end] memory and [blank_start]spatial[blank_end] orientation [blank_start]disinhibition[blank_end] emotional unconcern

[blank_start]Vascular[blank_end] dementia is due to the cumulative effects of many small strokes, thus sudden onset and stepwise deterioration is characteristic. Look for evidence of [blank_start]vascular[blank_end] pathology. Management: Manage [blank_start]vascular[blank_end] disease risk factors with [blank_start]lifestyle[blank_end] changes + [blank_start]medication[blank_end]

[blank_start]Alzheimer's[blank_end] [blank_start]disease[blank_end] is the acquired deficits of cognition, visual spatial skill, memory and verbal abilities. Histology: characterised by neuritic [blank_start]plaques[blank_end] and [blank_start]neurofibrillary[blank_end] tangles (distinguishes from other dementias). Results in progressive neuronal damage and loss of [blank_start]acetylcholine[blank_end].

Alzheimer's disease Management: [blank_start]Multidisciplinary[blank_end] approach Medication: 1st line: [blank_start]Donezepil[blank_end] (an [blank_start]Acetylcholine[blank_end] [blank_start]esterase[blank_end] inhibitor)

What is not a major component of idiopathic parkinson's disease?

Idiopathic parkinson's disease is due to the destruction of neurones in the [blank_start]substantia[blank_end] [blank_start]nigra[blank_end] where [blank_start]dopamine[blank_end] is produced. Management: [blank_start]L[blank_end]-[blank_start]Dopa[blank_end]

The afferent light reflex is due to the occulomotor nerve (CN3)

[blank_start]Horner's[blank_end] [blank_start]syndrome[blank_end] is when the sympathetic nervous system to the eye is compromised.

What can cause Horner's syndrome?

Presentation of Horner's Syndrome: Classic triad: Unilateral [blank_start]miosis[blank_end] (constricted pupil) Unilateral [blank_start]partial[blank_end] [blank_start]ptosis[blank_end] (eyelid drooping) Unilateral apparent [blank_start]enophthalmos[blank_end] (sunken eye) and Unilateral [blank_start]anhidrosis[blank_end] (inability to sweat)

[blank_start]Oculomotor[blank_end] [blank_start]nerve[blank_end] palsy presents as down and out pupil with a drooping eyelid.

Majority of the extrinsic eye muscles is controlled by the oculomotor nerve.

[blank_start]Trochlear[blank_end] [blank_start]nerve[blank_end] palsy presents as difficulty looking down in an adducted position.

Trochlear nerve is very susceptible to trauma.

[blank_start]Abducens[blank_end] [blank_start]nerve[blank_end] palsy presents as difficulty with abduction of eyes.

Abducens nerve is rarely injured but trauma can cause compression of it.

[blank_start]Post[blank_end]-[blank_start]herpetic[blank_end] [blank_start]neuralgia[blank_end] is a persistent nerve pain that occurs at the site of a previous attack of shingles. It is difficult to treat but can be managed via neuropathic pain agents such as [blank_start]amitriptyline[blank_end] or gabapentin.

Ramsey Hunt Syndrome includes facial nerve palsy and hearing may be affected as a result.

What are unilateral causes for facial nerve palsy?

Vestibulocochlear nerve palsy causes [blank_start]sensorineural[blank_end] hearing loss. [blank_start]Vertigo[blank_end] is the sensation of the room spinning

[blank_start]Glossopharyngeal[blank_end] nerve damage can lead to ipsilateral diminished taste sensation

[blank_start]Recurrent[blank_end] [blank_start]laryngeal[blank_end] nerve is a branch of the vagus nerve which supplies muscles of [blank_start]phonation[blank_end]. It is commonly injured in [blank_start]neck[blank_end] surgeries, which can lead to a [blank_start]hoarse[blank_end] voice

Damage to the vagus nerve can manifest as [blank_start]ipsilateral[blank_end] failure to raise soft palate with [blank_start]uvula[blank_end] deviation to the opposite side

Damage to the accessory nerve will manifest as weakness in [blank_start]rotating[blank_end] the head to [blank_start]opposite[blank_end] side of lesion and the weakness in [blank_start]shrugging[blank_end] shoulders.

Hypoglossal nerve: A unilateral [blank_start]LMN[blank_end] lesion causes: tongue weakness and [blank_start]fasciculation[blank_end] tongue [blank_start]deviates[blank_end] in the [blank_start]direction[blank_end] of nerve lesion

What are the bulbar nerves, which all arise in the medulla and as a result, are commonly injured together.

Bulbar nerves all have similar pathologie that leads to dysphagia and dysarthria.

[blank_start]Pseudobulbar[blank_end] palsy: bilateral UMN lesion: Spastic tongue (not wasted) no fasciculations [blank_start]Exaggerated[blank_end] jaw jerk [blank_start]Emotional[blank_end] liability Traumatic brain injury or [blank_start]stroke[blank_end] [blank_start]Bulbar[blank_end] palsy: bilateral LMN lesion: Wasting of tongue with fasciculations [blank_start]Normal[blank_end] jaw jerk [blank_start]Myasthenia[blank_end] [blank_start]gravis[blank_end]

What is not a trigger for trigeminal neuralgia?

ften caused by [blank_start]compression[blank_end] at [blank_start]cerebellopontine[blank_end] angle Trigeminal neuralgia presents as severe [blank_start]pain[blank_end] (paroxysms of knife-like or electric shock). These pain spasms last for [blank_start]seconds[blank_end] with multiple episodes before a remission for [blank_start]months[blank_end] or even years before reoccurrence Treatment: [blank_start]carbamazepine[blank_end], surgical [blank_start]decompression[blank_end], or [blank_start]ablation[blank_end]