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16 Cards in this Set
- Front
- Back
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hallmarks of brainstem lesion
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(Terry Schiavo)
a. loss of pupillary reflex occurs early (makes sense b/c brainstem contains CN 3) b. absent/abnl oculomotor reflex (makes sense b/c brainstem contains CN 3) c. sudden coma onset |
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MCC coma?
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metabolic coma (supratentorial [cortex] AND infratentorial [brainstem], thus diffuse)
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what do these suggest?
-pupillary rxns preserved til late -motor signs are symmetrical |
metabolic coma
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focal cortical Sx (i.e. apashia, contralat hemiparesis/sensory) suggests?
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supratentorial lesion (cortex)
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apashia, contralat hemiparesis/sensory) suggests?
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supratentorial lesion (cortex)
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when do pts look away from lesion>?
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-irritative lesions (seizures)
-pontine gaze center lesion |
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when do pts look toward lesion?
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ablative lesion (infarct, hemorrhage)
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what does unilateral, dilated, fixed pupil suggest?
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third nerve palsy, consider early uncal herniation
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if eyes move non-conjugately (during Dolls eyes), what does this suggest?
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brainstem lesion
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if there is no eye mvmt (during dolls eyes), what does this suggest?
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either brainstem lesion or pt is in such deep coma that a stronger stimulus, such as calorics test, is req to drive the reflex
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calorics: defective slow phase suggests?
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brainstem pathology
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calorics: absent fast phase suggests?
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bilateral cortical dysfxn
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calorics tests what ?
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calorics test the oculovestibular reflex
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dolls eyes tests what?
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oculocephalic reflex
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decerebrate:
-def? -where is lesion? |
extension of upper extremities
-indicatges lesion in upper brainstem |
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decorticate:
-def? -where is lesion? |
-flexion of upper extremities
-lesion in hemisphere/capsule |
