In meningitis, which meninges are inflamed?
Pia mater and arachnoid mater
Symptoms of meningitis?
headache, neck stiffness, fever, photophobia, vomiting
Causative organisms of meningitis in neonates, 2-5 years, 5-30 years, and 30+?
neonates - e coli 2-5 - Haemophilius influenzae 5-30 - Neisseria meningitides 30+ - Strep pneumoniae
Complications of meningitis?
RICP, cerebral infarction, epilepsy, subdural empyema
What is encephalitis?
Infection of neural parenchyma
Symptoms of encephalitis?
Headache, fever, confusion, drowsiness, fatigue
Causative organisms of encephalitis?
HSV, CMV, HIV
What are prion disease examples?
Kuru, nvCJD, spongiform encephalopathy
What is normal ICP?
0-10 mmHg, up to 20mmHg when coughing or straining
What is raised ICP?
How is cerebral blood flow maintained in raised pressure?
Reduced blood flow, reduced CSF volume, brain atrophy
Symptoms of RICP?
headache, vomiting, papilloedema. Cushing reflex - increased blood pressure, reduced HR, irregular respiration
What are the 3 types of herniation of the brain? Explain them and their resulting effects
Subfalcine - cingulate gyrus pushed under free edge of falx cerebri. results in ischemia in parietal and frontal lobe and corpus callosum due to compression of ACA.
Tentorial - Uncus herniates through tentorial notch. Damage to CN 3 and occlusion of cerebellar arteries
Tonsillar - cerebellar tonsils pushed into foramen magnum wtih compression of brainstem. cardiac arrest and apnoea
Most common primary tumours of CNS? benign and malignant
benign - meningioma malignant - astrocytoma
What is primary damage of a head injury?
The movement of the brain inside the skull. Can be divided into: - focal damage - bruising and laceration of brain at initial site of impact as well as the opposite side of the brain - Diffuse damage - tearing of axons due to injury. results in gliotic scarring, can lead to dementia
What is the cause of a tension headache? How does it present? how do you treat?
neurovascular irritation from excessive tension in the scalp muscles. symptoms - tight band sensation, pressure behind eyes treat - paracetemol, analgesic withdrawal
`What is a migraine headache? How does it present?
Recurrent headache with visual and GI disturbances. 4 phases - well being before attack, prodromal symptoms, main attack, sleep and feeling of being drained after. prodromal symptoms - aphasia and sensory changes
What is a cluster headache? Which age group is it most common in?
Severe pain clustering around one eye. Most common in males from 30-40 yo
What is temporal arteritis? Symptoms?
Inflammation of the arteries of the head.Artery becomes hard, tortuous, thickened. Symptoms - facial pain and visual provlems. severe malaise and tiredness.