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40 Cards in this Set
- Front
- Back
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What is the bleeding site of an epidural bleed?
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Middle meningeal artery
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Bleeding site for subdural bleed?
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Cortical bridging veins
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Bleeding site for Subarachnoid bleed?
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Circle of Willis, often at middle cerebral artery (MCA) branch
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Bleeding site for a parenchymal bleed?
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Basal ganglia, internal capsule, thalamus
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What does one see on CT for an epidural bleed?
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Bioconcave disk not crossing suture lines
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What type of bleed may start 1-2 weeks after trauma?
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Subdural
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What does one see on CT for a subdural bleed?
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Crescentic pattern extends across suture lines
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What are the causes of a subdural bleed?
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Trauma, coagulopathy common in elderly
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What are the causes of a subarachnoid bleed?
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AV malformation, berry aneurysm, trauma
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What do berry aneurysms cause?
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Severe sudden HA, CN III palsy
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What does one see on a subarachnoid bleed in the. CSF?
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Xanthochromia
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How is a berry aneurysm diagnosed?
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Cerebral angiogram
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What is the treatment of a berry aneurysm?
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Nimodipine to prevent vasospasm & resultant secondary infarcts
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What is the treatment of a parenchymal bleed?
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With a parenchymal bleed have increased ICP. Therefore mannitol, hyperventilate, steroids/and or ventricular shunt
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Dark circles (bruising) about the eyes, signifying orbital fractures
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Racoon's Eyes
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Ecchymoses over the mastoid process, indicating a fracture there
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Battle's sign
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Headache awakening pt at night or is worse in morning after waking
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Tumor
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N/V, bradycardia with hypertension, Cheyne-Stokes respirations (Cushings triad), and papilledema
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ICP
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What is the tx for all primary Tumors of the brain except for prolactinoma, and lymphoma?
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Excision
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What is the first line tx for prolactinoma?
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Bromocriptine
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What is the most common CNS Neoplasm?
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Metastatic
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Small circular lesion, often multiple at gray-white junction
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Metastatic brain tumor
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Most common primary CNS Neoplasm?
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Glioblastoma Multiforme
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Large, irregular ring enhancing due to central infarction (outgrows blood supply)
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Glioblastoma Multiforme
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Slow growing and benign
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Meningioma
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Occurs in children, 60% sporadic, 40% familial (often bilateral)
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Retinoblastoma
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Found in cerebellum in floor of fourth ventricle, common in children
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Medulloblastoma
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Compresses optic chiasm and hypothalamus
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Craniopharyngioma
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Bilateral gynecomastia, amenorrhea, galactorrhea, impotence, bitemporal hemianopsia
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Prolactinoma
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Most common CNS tumor in AIDS pts, MRI: ring enhancing lesion difficult to distinguish from toxoplasmosis
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Lymohoma
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Usually affects CN VIII (acoustic neuroma), tinnitus, deafness, increased ICP
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Schwannoma
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Increased CSF resulting in enlarged ventricles
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Hydrocephalus
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Increased ICP, decreased cognition, headache, focal findings, in children separation of cranial bones leads to grossly enlarged calvaria
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Hydrocephalus
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How is the diagnosis if hydrocephalus made?
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Dilated ventricles on CT/MRI
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Ventricle dilation after neuron loss (e.g., stroke, CNS dz)
Sx due to neuron loss, not ventricular dilation in this case Tx: none indicated |
Hydrocephalus ex vacuo
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What is the classic triad for normal pressure hydrocephalus?
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Bladder incontinence, dementia, ataxia ("wet, wacky, wobbly")
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Bladder incontinence, dementia, ataxia
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Normal pressure hydrocephalus
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What causes normal pressure hydrocephalus?
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Decreased CSF resorption across arachnoid villi.
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What is the tx for normal pressure hydrocephalus?
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Diuretic therapy, repeated spinal taps, consider shunt placement
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Communicating spontaneous increased ICP, commonly seen in obese young females
CT: no ventricle dilation (may even be shrunken) |
Pseudo tumor cerebri
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