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Flashcards in Revision 2 Deck (198)
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121

what are the functions of the frontal lobe

voluntary movement
reasoning
executive function
personality
inhibition
initiative
expressive language
habit learning
emotional control

122

what are the functions of the parietal lobe

knowing left from right
reading
writing
body orientation
calculation
two point discrimination
graphaethesia

123

what do lesions in the DOMINANT parietal lesion cause

dysphasia
dyscalculia
dyslexia (difficuly learning to read. interpret words, letters and symbols)
apraxia
agnosia
gerstmann syndrome (acalculia, agraphia, finger anomia, difficulty in differentiation of right and left)

124

what is apraxia

inability to perform complex movements in the presence of normal motor, sensory and cerebellar function

125

what is agnosia

tactile- inability to recognise or discriminate objects through touch

126

what is agraphia

inability to write

127

what is finger anomia

cant recognise own or other peoples fingers

128

what does a lesion in the NON DOMINANT parietal lobe cause

spatial disorientation
constructional apraxia
dressing apraxia
anosognosia (lack of self awareness of own medical illness)

129

what are the functions of the temporal lobe

understanding speech
memory
hearing
emotions
sense of identity
recognising faces

130

what do strokes in the dominant half of brain often have

language affected which has major implications for rehab

131

what is the acute treatment for an ischaemic stroke

Alteplase clot buster 0.9 mg/kg (max 90mg)
10% over 60 mins
Rest over 8 hours
MUST be given within 4.5 hours of symptom onset

132

what is a TACS

total anterior circulation stroke
all three of:
-unilateral weakness and/or sensory weakness of face, arm and leg
-homonymous hemianopia
-higher cerebral dysfunction (dysphasia, visuospatial disorder)

133

what is a PACS

partial anterior circulation syndrome
two of:
-unilateral weakness and/or sensory weakness of face, arm and leg
-homonymous hemianopia
-higher cerebral dysfunction (dysphasia, visuospatial disorder)

134

what is a POCS

posterior circulation syndrome
one of:
-cerebellar/ brainstem syndrome
-loss of consciousness
-isolated homonymous hemianopia

135

what is a LACS

lacunar syndrome (subcortical stroke due to small vessel disease)
one of:
-unilateral weakness and/or sensory deficit of face and arm, arm and leg or all three
-pure sensory stroke
-ataxic hemiparesis

136

what do subdural haematomas look like on MRI

banana

137

explain the slow onset of symptoms in a subepidural haematoma

bridging veins rupture
these are low pressure so blood spreads around brain before displacing it, gradual increase in symptoms

138

what vessel is classically ruptured in an extradural haemorrhage

middle meningeal artery (runs under pterion)

139

what is the formula for cerebral perfusion pressure

CPP= MAP - ICP

140

how do you remember how much each segment of the GCS scores

eyes (four letters)
speak (five letters)
motor (M6 motorway)

141

what is the minimum GSC score

3

142

what GCS score= coma

<8

143

what are the headache red flags

new onset headache >55
known/ previous malignancy
immunosuppressed
early morning HA
excerbation by valsalva
significant trauma in Hx
coagulopathy with trauma

144

what is the management for migraines

Diary to find triggers – then exclude triggers
NSAIDS eg 900mg Aspirin
Triptans (oral first) - must be at start of headache and repeated only once.
More than 3 attacks in a month – prophylaxis:
-Propranolol
-Topiramate (loads of side effects, start slow)

Remember contraception issues in women

145

what are the symptoms of trigeminal neuralgia

severe stabbing unilateral pain, v severe
Duration: 1sec to 90 secs
Frequency: 10 to 100 day
Bouts pain may last from a few weeks to months before remission
more common in females
any frequency
cutaneous trigger

146

what is the main drug used to treat trigeminal neuralgia

P450 inducer

147

what can trigger cluster HAs

alcohol

148

what are the features of a cluster HA

more common in males
boring pain
V. severe
orbital
15-180 mins
1-8 per day
autonmic features

149

what are the features of paroxsymal hemicrania

more common in females
boring pain
v severe
orbital
lasts 2-45 mins
1-40 per day
autonomic features
responds to endomethicin
mechanical trigger

150

what are the features of SUNCT

(short lasting unilateral neuralgiform HA with conjunctival injection and tearing)
more common in women
stabbing pain
severe
orbital
15-120 seconds
1 a day- every 30 hours
autonomic features
cutaneous trigger