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Neuro Chapter 5 #131 cards
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Lateral ventricles-->3rd ventricle (foramen of monroe) 3rd ventricle-->4th ventricle (sylvian aqueduct) out through foramina of Luschka and Magendie, into subarachnoid space, up to arachnoid granulations to be reabsorbed into bloodstream.
- migraine - cluster headache
Often occurs during "aura" preceding migraine. Wavy, zigzagging, shimmering lines in vision.
- more common in males. - drilling behind one eye. - headaches multiple times per day over a few weeks, then vanish for a few months. - pulsing headaches; lower grade than migraine.
- mild to moderate dull pain. - occurs from time to time, lasts for hours. - sometimes can last daily for years (seen in posttraumatic headache, e.g. from concussion)
- headache and elevated intracranila pressure with no mass lesion.
Any distortion of normal brain geometry due to a mass lesion. Can be as subtle as mild flattening (EFFACEMENT) of sulci
1. compression/destruction of adjacent regions of brain. 2. raise ICP 3. displace nervous system structures causing herniation (shifted into another compartment)
1. Headache 2. Altered mental status (esp. irritability and depressed level of alertness and attention) 3. nausea/vomiting 4. papilledema 5. visual loss 6. diplopia 7. cushings triad
1. hypertension 2. bradycardia 3. irregular respirations
Engorgement/elevation of optic disc. Classic sign of elevated intracranial pressure. Often not present in the acute setting.
Formed by volume of CSF, blood, and brain tissue. Normal ICF = less than 20 cm H20 or less than 15 mmHg
Herniation of the medial temporal lobe, especially the uncus (uncal herniation).
Herniation of uncus (medial temporal lobe) through the tentorial notch. Clinical triad of "blown" (fixed and dilated) pupil, hemiplegia, and coma. Causes compression of CN III--> ipsilateral blown pupil.
Central downward displacement of brainstem.
Herniation of cerebellar tonsils downward through foramen magnum. Compresses medulla, leading to respiratory arrest and DEATH.
Uncal herniation = flexor posturing Tonsillar herniation = extensor posturing
Cingulate gyrus and other brain structures herniate under falx cerebri. No significant clinical features like others.
Reversible impairment of neurologic function for a period of minutes-hours following a head injury.
MEDICAL EMERGENCY. Location: space between dura and skull. Usual cause: rupture of middle meningeal artery due to fracture of temporal bone. Appearance: lens-shaped biconvex hematoma.
(*chronic and acute*) Location: between dura and arachnoid. Usual cause: rupture of the bridging veins. Appearance: crescent-shaped hematoma.
Seen in: elderly (smaller brains). may have no history of trauma. vague symptoms. can have focal seizures.
Associated with serious injuries. Density depends on age of blood.
Depends on age of blood. Hyperdense: (acute blood) bright on CT scan. Isodense: after 1-2 weeks. Hypodense: 3-4 weeks.
Sometimes seen in mixed-density hematomas. Denser acute blood settles to bottom.
WORST HEADACHE OF LIFE. Causes: 1. aneurysm 2. AVMs (less common)
Usually arise from aterial branch points near circle of Willis. Balloon-like outpouchings of vessel wall with fragile dome that can rupture. Most commonly in anterior communicating artery.
Excess CSF in intracranial cavity.
1. excess CSF production 2. obstruction of flow at any point in the ventricles or subarachnoid space 3. decrease in reabsorption via the arachnoid granulations
Caused by impaired CSF reabsorption in the arachnoid granulations, obstruction of flow in subarachnoid space, or (rarely) by excess CSF production.
Caused by obstruction of flow within the ventricular system.
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