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19 Cards in this Set
- Front
- Back
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Transient ischemic attack
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Reversible synptoms last less than 24 hours. Due to platelet thrombi or atheroemboli
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Infarction stroke
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85% of strokes. Can be thrombotic (atherosclerosis) white infarct or embolic (thromboemboli or atheroemboli) hemorrhagic infarct
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Clinical features of medial cerebral artery stroke
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Contralateral hemiparesis and sensory loss, aphasia if Broca area in the left hemisphere is involved, deviation of head and eyes toward side of lesion
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Types of hemorrhagic strokes
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Intraparenchymal, epidural, subdural, subarachnoid. Hemorrhagic strokes are 15% of all strokes
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Causes of hemorrhagic stroke
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Hypertension is MCC due to formation of microaneurysms that tend to rupture in basal ganglia or cerebellum. Arteriovenous malformations, amyloid, neoplasms, vasculitides
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Clinical features of hemorrhagic stroke
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Acut onset of severe headache, nausea, vomiting and coma
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Epidural hemorrhage
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Due to trauma and skull fracture with tear of middle meningeal dural artery. "Talk and die" syndrome. Leads to herniation if not promptly evacuated
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Subarachnoid hemorrhage
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MCC: ruptured berry aneurysm. Sudden thunderclap headache, nuchal rigidity, neurological deficits and coma
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Berry aneurysms
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Thin-walled saccular outpuchings consisting of intima and adventitia only. Cause of subarachnoid hemorrhage. Associated with Marfan, Ehlers-Danlos and adult polycystic kidney disease
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Spina bifida occulta
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Bony defect of vertebral arch
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Meningocele
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Bony defect with outpuching of the meninges
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Meningomyelocele
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Defective bony arch with outpuching of meninges, spinal cord and spinal roots. May lead to paraplegia and urinary incontinence
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Myelocele
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Defective bony arch with complete exposure of spinal cord. May lead to paraplegia and urinary incontinence
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Multiple sclerosis
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Chronic relapsing-remitting episodes of demyelination in brain and spinal cord with progressive neurological deficits. Blurred vision or loss of vision, diplopia and vertigo, loss of sensation or weakness in one leg, hemiparesis. TH1 cytokines (IF-g, TNF) facilitate attack; TH2 cytokines (IL-4, IL-10) retard attack.
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Parkinson disease clinical features
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Loss of dopaminergic neurons in the substantia nigra. Resting tremor, rigidity and akinesia, expressionless face. Rx.: levodopa
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Microscopic features of Parkinson disease
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Lewy bodies: intracytoplasmic round eosinophilic inclusions tha contain alpha-synuclein; EM shows filaments of cytoskeletal origin
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Huntington disease clinical features
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Degeneration of GABAnergic neurons of caudate nucleus. Chrorea, dementia btween ages 20-40. Triplet repeat CAG and features of genetic anticipation and imprinting
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Clinical features of Alzheimer disease
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MCC of dementia. Insidious inset of memory impariment, alterations in mood and behavior, aphasia and apraxia
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Microscopic features of Alzheimer disease
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Amyloid precursor protein (APP gene) on chromosome 21 (Down syndrome). AB amyloid from the APP protein. Senile plaques: AB amyloid tangled with neuritic processes, microglia and astrocytes. Neurfibrillary tangles: intraneuronal aggregates of paired helical filaments protein.
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