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34 Cards in this Set
- Front
- Back
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Alzheimer's
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- dec ACh
- cortical atrophy most pronounced in frontal lobe and hippocampus - Senile plaques = extracellular Beta-amyloid core - can cause amyloid angiopathy -> intracranial hemorrhage - Neurofibrillary tangles (intracellular, abnormally phophorylate tau protein = insoluble cytoskeletal elements; tangles correlated w/ degree of dementia) Early Onset APP (21) - beta-secretase; gamma-secretase Presenilin-1 = Chrom 14 Presenilin-2 = Chrom 1 Late Onset = ApoE4 (chrom 19) - involved in removing Beta-amyloid ApoE2 is protective |
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Pick's dementia
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- Frontotemporal dementia
- Dementia, aphasia, PARKINSON's, CHANGE in personality - SPARES PARIETAL LOBE and Posterior 2/3 of TEMPORAL gyrus Pick bodies (intracellular, aggregated tau protein) FRONTOTEMPORAL ATROPHY |
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Lewy body dementia
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Parkinson's w/ dementia and HALLUCINATIONS; falls and syncope
alpha-synuclein defect - Lewy body (intracytoplasmic eosinophilic inclusions containing ubiquitin) |
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Creutzfeldt-Jakob disease (CJD)
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- Rapidly progressive (wks to months) dementia w/ MYOCLONUS
-Spongiform cortex -Prions (alpha helix -> Beta sheet [resistant to proteases]) - EEG recurrent bursts of high-voltage slow waves |
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Other causes of dementia
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Multi-infarct (2nd most common in elderly)
Syphilis HIV Vit. B12 def Wilson's disease TSH |
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location of defect in
Parkinson Panic Attack Huntington's Anorexia |
Parkinson = substantia Nigra
Panic Attack = locus ceruleus -> makes NE located in caudal pontine gray Huntington's = Caudate -> NMDA receptor depleted anorexia = Raphe Nuclei -> 5-HT3 |
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Multiple Sclerosis
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intention tremor = cerebellum
optic neuritis tx = INF-Beta |
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Guillain-Barre
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Findings =
inc CSF protein w/ normal cell count (albuminocytologic dissociation); Inc protein -> papilledema Campylobacter jejuni, HSV tx = Respiratory support; plasmapheresis, IVIG |
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PML
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demyelination of CNS due to destruction of oligodendrocytes
Assoc. w/ JC virus and seen in 2-4% of AIDs patients (reactivation of latent viral infxn) Rapidly progressive, usually fatal |
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Metachromatic leukodystrophy
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AR - lysosomal storage diseas
- due to arylsulfatase A def - buildup of sulfatides leads to impaired production of myelin sheath |
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Charcot-Marie Tooth disease
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- aka hereditary motor and sensory neuropathy (HMSN)
- groups of progressive hereditary nerve disorders related to the defective production of proteins involved in the structure and fxn of peripheral nerves or the myelin sheath |
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Partial seizures
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- 1 area of the brain; most commonly originates in the medial temporal lobe.
- often preceded by seizure aura Simple partial = consciousness intact Complex partial = impaired consciousness |
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Absence seizure
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- blank stare
- Ethosuximide |
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Myoclonic seizure
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quick, repetitive jerks
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Tonic-clonic seizure
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- grand mal
- alternating stiffening and movement |
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tonic seizure
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stiffening
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Atonic seizure
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= "drop" seizures (falls to floor)
- commonly mistaken for fainting |
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Headache
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pain due to irritation of structures such as dura, cranial nerves, or extracranial structures, not brain parenchyma itself
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Migraine headache
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- unitlateral;
4-72 hrs of pulsating pain w/ nausea - photophobia or phonophobia +/- aura of neurologic symptoms - due to irritation of CN V and release of substance P, CGRP, vasoactive peptides Tx: propranolol; NSAIDS; sumatriptan for acute migraines |
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Tension headache
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bilateral
> 30 mins of steady pain - Not aggravated by light or noise - no aura tx: NSAIDs |
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Cluster headache
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- unilateral; repetitive (clusters) brief headaches characterized by periorbital pain assoc. w/
- ipsilateral lacrimation; rhinorrhea, horner's syndrome - Much more common in MALES. Tx = sumatriptan - EtOH predisoping factor |
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Vertigo
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- illusion of movement, not to be confused w/ dizziness or light headedness
Peripheral vertigo - more common; inner ear etiology (semicircual canal debris, vestibular nerve infxn, Meniere's disease) - Postional testing -> delayed horizontal nystagmus Central vertigo - brain stem or cerebellar lesion (e.g vestibular nuclei, posterior fossa tumor) - Positional testing -> immediate nystagmus in any direction; may change directions |
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Sturge- weber
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- port-wine stains (aka nevus flammeus)
- ipsilateral leptomeningeal angiomas - pheochromocytomas - Glaucoma, seizures, hemiparesis, and mental retardation - occurs sporadically |
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Tuberous sclerosis
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=AD
hamarotmas in CNS, skin, organs - Cardiac rhabdomyoma - renal angiomyolipoma - subependymal giant cell astrocytoma - MR, seizures, hypopigmented "ash leaf spots" shagreen patch sebaceous adenoma |
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NF type I
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= AD; mutated NF-1 gene on chromosome 17
-Cafe au lait -Lish nodules (pigmented iris hamartomas) - neurofibromas in skin - optic gliomas - pheochromocytomas |
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VHL
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= AD; chromosome 3
- cavernous hemangiomas = skin, mucosa, organs - bilateral RCC - hemagioblastoma in retina, brain stem, cerebellum - Pheochromocytomas |
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Glioblastoma multiforme (grade IV astrocytoma)
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- stains astrocytes for GFAP
- pseudopalisading pleomorphic tumor cells |
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Meningioma
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- most often occurs in convexities of hemispheres and parasagittal region
- arises from arachnoid cells external to brain - resectable PSAMMOMA BODIES (laminated calcifications) |
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Schwannoma
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= localized, resectable
- usually found at cerebellopontine angle = S-100 positive - bilateral schwannoma found in neurofibromatosis type 2 |
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Oligodendroglioma
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- fried egg cells
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Pilocytic (low-grade) astrocytoma
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= most often found in posterior fossa
- GFAP positive - benign, good prognosis - ROSENTHAL FIBERS = eosinophilic, corckscrew fibers. |
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Medulloblastoma
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- highly malignant cerebellar tumor
- primitive neuroectodermal tumor - can compress 4th ventricle, causing hydrocephalus Small blue cells; radiosensitive |
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Ependymoma
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= ependymal cell tumors mot commonly found in 4th ventricle
- can cause hydrocephalus - poor prognosis perivascular pseudorosettes - more vacuolated than medulloblastoma |
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Hemangioblastoma
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- most often cerebellar
- associated w/ VHL found w/ retinal angiomas - can produce EPO -> secondary polycythemia Foamy cells and high vascularity are characteristic |
