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69 Cards in this Set
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CNS/PNS
neuroectoderm neural crest mesoderm |
NE: CNS, ependymal cells, oligodendroglia, astrocytes
NC: schwann cells, PNS neurons M: microglia |
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Nissl substance (RER)
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not in axons, but in dendrites & cell body
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astrocytes
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GFAP
bbb reactive gliosis |
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Oligodendroglia
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multiple CNS
fried eggs MS |
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schwann cells
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1 PNS axon
axonal regeneration Guillain-Barre Syndrome Acoustic neuroma |
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Free Nerve Endings
Meissner's corpuscles Pacinian Corpuscles Merkel's Disks |
FNE: C, Aδ; all skin, epidermis, some viscera; pain and temp; unmyelinated; slow
MC: glabrous skin; dynamic fine touch; quick PC: deep skin layers, ligaments, joints; vibration, pressure MD: cup-shape, unencapsulated; hair follicles; static touch; slow |
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NE
DA 5-HT ACh GABA |
NE: ↑anxiety, ↓depression; locus ceruleus
DA: ↑ schizo, ↓park.↓depression; ventral tegmentum, SNc 5-HT: ↓anxiety, depression; raphe nucleus ACh: ↓Alz, Hunt., REM ↑park; basal nucleus of Meynert GABA: ↓anxiety, hunt; nucleus accumben |
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HYPOTHALAMUS
SON PVN Lateral VMA Ant Post SN SCN |
SON: ADH
PVN: Oxytocin Lateral: hunger; destroy=anorexia; (-)leptin VMA: satiety; destroy=hyperphagia; (+)leptin Ant: cooling, pArasym Post: heat; SNS DM: savage behavior & obesity SN: sex urges SCN: circadian rhythm & eye input |
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THALAMS
LGN MGN VPL VPM VA/VL |
LGN: light=vision
MGN: music=hearing VPL: body sensation (dorsal column, spinothalamic tract) VPM: makeup=face (CN5) VL/AL: motor |
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CEREBELLUM
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mossy fibers/climbing fibers-->cerebellar cortex-->purkinje-->deep nuclei-->superior cerebellar peduncle-->output
vestibulocerebellum=folliculornodular+vermis-->fastigial (difficult balance, eye movment, medulloblastoma) sphino cerebellum=vermis+paravermal-->fastigial+interpose (postural instability, slurred speech, pendulum knee jerks) lateral cerebrospellum=lateral hemisphere-->dentate (no coordination, difficult control movement; termor extremitieis) deep nuclei (L-->M: dentate, embliform/globose=interpose, fastigial) |
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parkinson
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TRAP
Tremor rest rigidity cogwheel Akinesia, α-synuclein (lewy body) Postural instability, shuffling gait, blank stare depigment of substantia nigra pars compacta (loss of DA) |
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hemiballismus
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contralateral subthalamic nucleus
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huntington's
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CAG repeat
Caudate loses ACh and GABA Crazy Chorea (BG lesion) Chr4 Cuarenta y/o enlarged lateral ventricles asthestosis (snakelike) |
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pontine
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affects smiling (CN7)
lateral vision (CN4) |
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amygdala (bilateral)
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KLUVER BUCY syndrome
hyperorality hypersexuality disinhibited behavior |
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right parietal lobe
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hemispatial neglect
(no makeup on 1 side of face) |
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L parietal lobe
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gerstmann syndrome
agrafia aclaculi finger agnosia L-R disorientation |
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RAS
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reticular formation, locus ceruleus, raphe nucleus
arousal wakefulness |
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mammillary bodies
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wernicke-korsakoff syndrome
COCA confusion ophthalmoplegia confabulation ataxia |
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BG
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tremor at rest
chorea athetosis |
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cerebellar hemisphere
cerebellar vermis |
CH: intention tremor
limb ataxia; lateral location ipsilateral CV: truncal ataxis dysarthria |
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paramedian pontine reticular formation
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eyes look away
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frontal eye fields
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eyes look toward lesion
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superior calliculi
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paralysis of upward gaze (paranaud syndrome)
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central pontine myonosus
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hypoNa+
irreversible dysarthria |
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anterior spinal artery
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medullary syndrome
contralateral hemiparesis LE medial lemiscus ipsilateral paralysis of CN12 pain & temp present |
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recurrent laryngeal
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hoarseness
thyroidectomy |
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Weber syndrome
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infarct paramedian branches of PCA
not occipital lobe cerebral peduncle lesion: contralateral spastic paralysis CN3 palsy (ipsilateral) |
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anterior communicating artery
posterior communicating artery |
Ant: most common site of aneurysm
visual field defects Post: aneurysm CN3 palsy |
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posterior cerebral a.
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PCA: visual cortex, macular sparing, medulla
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lateral straite
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arteries of stroke
pure motor emiparesis-->internal capsule, caudate, putamen, globus pallidus charcot-bouchard microaneurymes |
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watershed zones
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severe hypoTN
upper leg/upper arm weakness defects in higher-order visual processing |
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AICA
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face sensation and hearing loss ipsilateral
horner's similar to PICA LATERAL PONS |
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PICA
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LATERAL MEDULLA
Wallenberg Syndrome nystagmus ipsilateral ataxia n/v horner's syndrome lost pain/tmep |
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basilar artery
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lock-in-syndrome
pons, midbrain, cerebrum |
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stroke of anterior circle
stroke of posterior circle |
ANT: sensory and motor dysfunction
aphasia POST: CN deficits coma cerebellar deficits |
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Epidural hematoma
Subdural hematoma Subarachnoid hemorrhage Parenchymal hematoma |
bEla: biconcave, lucid, artery (middle menigeal); no suture line, cross falxtentorium
SDcgv: convex, gradual, veins, cross suture lines not falxtentorium SA: worst hA; berryAneurysm, 2-3 days, vasospasm imodipine (red=acute, yellow=chronic by LP) PH: htn, amyloid angiopathy, DM, tumor at lenticulate straie |
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ischemic brain disease
Hemorrhagic stroke Ischemic Stroke TIA |
H: intracerebral bleed; aneurysm, 2⁰ ischemia, ↑fragility
I: emboli (a-fib, carotid dissection, patent foramen ovale, endocarditis) or lacunar strokes 2⁰htn; tPa 3hrs TIA: brief, focal, reversible <24hrs |
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Ischmic Brain Disease imaging
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dx.: CT-->ischemia
CT-->nothing-->hemorrhage (MRI) or <24hrs TIA MRI: 3-30 mins bright for 10 days CT: dark only after 24 hrs |
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Brain Ventricles
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lateral ventricles
foramen of monroe 3rd ventricle cerebral aqueduct/sylvius 4th ventricle foramen of luschka(2) or magendie subarachnoid superior saggital sinus |
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Hydrocephalus
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CT scan; reversible
triad: wacky (dementia), wet (urine incontinence), wobbly (gait problems) nL/communicating: no absorption by arachnoid granulations (menigitis) Obstruct/noncomun: block/stenosis Hydrocephalus ex vacuo: ↑CSF atrophy Pseudotumor cerebri: overweight young females, worst HA; papilloedema; ↑CSF pres, ↓outflow; nL ventricle; ; vitA, TCAs, OCPs; tx: acetalzolamide; no LP |
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Spinal tracts
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Dorsal: pressure, proprioception, touch, vibration; medulla (gracilus in middle near penis)
Corticospinal: voluntary motor (legs lateral); medulla; anterior horn Spinothalamic: (free nerve) pain, temp; anterior white commissure |
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UMN
LMN |
U: ↑reflexes, ↑tone, babinksi, spastic paralysis, class knife spacitiy
L: ↓reflexes, ↓tone, atrophy, fasciculation, |
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poliomyelitis
werdnig hoffman disease |
LMN lesions only
destroyed anterior horns-->flaccid paralysis P: poliovirus fecal-oral; ↑lymphocytes WH: AR, floppy baby, tongue fasciculations, botulism=honey |
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Multiple sclerosis
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random, asymetric white matter lesions
autoimmune demyelination SI3N Scanning speech, Intention tremor, Incontinence, Internuclear opthalmoplegia, Nystagmus ↑IgG/protein, periventricular plaques, oligodendrocyte loss, preserved axons, oligoclonal bands MRI: lesions of different ages (head, spinal cord) tx: beta-interferon, cyclosporine, symptomatic |
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ALS
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UPM, LMN lesion with signs
not affect sensory SOD1 betel nut ingestion |
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Complete occlusion
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spares dorsal column & tract of lissaue
upper thoracic: watershed area artery of adamkiewicz: suppplies ASA below T8 |
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Tabes Dorsalis
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3⁰ syphillis: dorsal column, dorsal roots
charcot joints shooting/lightening pain APR no DTRs |
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syringomyelia
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damaged crossing fibers of spinothalamic tract (bilateral loss of pain & temp)
enlarged central canal chaiari 2 malformation (C8-T1) |
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vit B12, vit E, Friederich's Ataxia
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demyleination of dorsal columns,
lateral corticospinal tracts, spinocerebellar tracts ataxic gait, hyperreflexia, impaired position, vibration senses FA: AR GAA, staggering, falling frat bro with pes cavus, hypertrophic cardiomyopathy, kyphoscoliosis, impaired mitochondrial functiong.all 4 limbs affected |
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Brown-Sequard syndrome
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below T1
contralateral: spinothalamic ipsilateral: corticospinal, dorsal column, loss all sensation at level: LMN=flaccid paralysis |
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Horner's syndrome
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PAM is horny
above T1 Ptosis Anhidrosis Miosis ipsilateral compression of brachial plexopathy pancoasts, brown-sequard syndrome, late-stage syringomyelia cluster HA=partial |
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Nucleus Solitarius
Nucleus aMbiguus Dorsal motor nucleus |
NS: sensory (taste, baroreceptors, gut distention): CN7,9,10
NA: Motor pharynx, larynx, upper esophagus; CN9,10,11 DMN: autonomic (PNS) to heart, lungs, upper GI |
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Conductive HL
Sensorineural HL |
C: BC>AC rinne; weber to affected ear
S: AC>BC rinne; weber to nL ear |
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Alzheimer's disease
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cortical atrophy ↓ACh
senile plaques (β-amyloid) abnL phosphorylated tau protein down syndrome chr1,14,19 (APOE4, AD), 21 (p-App gene) |
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Pick's Disease
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frontotemporal dementia
intracellular, aggregated tau protein) spares parietal lobe & post. 2/3 of superior temporal gyrus |
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Lewy Body Dementia
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hallucinations + parkinsoniam
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CJD
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rapidly progressive
myoclonus spongiform cortex prions |
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Harono's
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hippocampus eosinophilic Alzheimer's
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Progressive Multifocal Leukoencephalopathy
Acute disseminated/postinfectious encephalomyelitis Metachromatic Leukodystrophy Charcot-Marie-Tooth Disease |
PML: JC virus destroys oligodendrocytes; AIDS, rapid progressive, fatal
ADE: multifocal perivenular inflammation, demyelination (chickenpox, measles) or vaccinations (rabies, smallpox) MLD: AR buildup of sulfatides (lysosomal storage disease) impairs myelin sheath production CMTD: HMSN (hereditary); peripheral nerves of myelin affected |
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aids dementia
lipfoscin granules herpes encephalitis harono's |
AD: multinucleated giant cells
LG: intranucleophile of aging & heart HE: necrosis of temporal lobes H: hippocampus eosinophilic alzheimer's |
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seizures
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PARTIAL: 1 area
simple partial: conscious complex partial: impaired GENERAL: diffuse absence/petit mal: blank stare myoclonic: quick repetitive jerks tonic-clonic/grand mal: alternate tonic: stiff atonic: drop (mistake for faint) |
chlidren: genetic, infection, trauma, congenital, metabolic
adults: tumors, trauma, stroke, infection elderly: stroke, tumor, trauma, metabolic, infection |
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HEADACHE
migraine tension cluster |
M: 4-72hrs, light/noise; aura, pulsatile; CNV irritation; substance P; CGRP; vasoactive peptides
T: >30mins; bilateral C: repetitive 4-8weeks; ipsilateral lacrimation; rhinorrhea; horner's males; tx O2 |
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NEUROCUTANEOUS DISORDER
Sturge-Weber Syndrome Tuberous Sclerosis NF1 (vonRecklinghausen's disesase) vHL disease |
SWS: port-wine stain; ipsilateral leptomeningeal angioma; sporadic
TS: hamartomas; cardiac rhabdomyoma; renal angiomyolipoma; subependymal giant cell astrocytoma; MR; seizures; "ash leap spots" AD NF1: cafe-au-lait spots; Lisch Nodules; neurofibromas AD chr17 VHL: delete VHL on chr3p AD; cavernous hemangiomas; RCC; hemangioblastoma |
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ADULT PRIMARY BRAIN TUMORS
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Metastases: lung, breast, melanoma, RCC, GI
Glioblastoma multiforme (astrocytoma): #1; poor prognosis; butterfly glioma; GFAP; pseudopalisading Meningioma: #2; spindle cells; psammoma bodies Schwannoma: #3; CN8; S100; bilateral=NF2 Oligodendroglioma: fried egg calcification; chicken-wire capillary pattern PituitaryAdenoma: prolactinoma; bitemporal hemianopa; hyper/hypopituitarism; rathke's pouch |
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CHILDHOOD BRAIN TUMORS
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Pilocytic Astrocytoma: #1; well-circumscribed; GFAP; S100; rosenthal fibers; hair-like; cilial processes & microcysts; sometimes supratentorial
Medulloblastoma: #2; PNET; compress 4th ventricle; horner-wright rosettes Ependymoma: #3; in 4th ventricle; perivascular pseudorosettes; rod shape blepharoplasts Hemangioblastoma: vHL; polycythemia; foamy cells; highly vascularity Craniopharyngioma: benign; bitemporal hemianopia; cholesterol cysts; calcification |
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HERNIATION
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cingulate/subfalcine under falx cerebri
uncal downward transtentorial/central herniation cerebellar tonsillar herniation into foramen magnum |
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Uncal herniation
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ipsilateral dilated pupil/ptosis=blown pupil
contralateral homonymous hemianopia ipsilateral paresis (crus cerebri=kernohan's notch) duret hemorrhages--paramedian artery rupture (caudal displace of brain stem) |
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Ring-enhancing lesion
Uniformly... Heterogenitiy.... |
REL: toxoplasmosis; abscess, AIDs, metasteses, lymphoma
UEL: meningioma; lymphoma, metasese HEL: glioblastoma multiforma |
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