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Neuro Review Quiz. CSF findings in meningitis. Turbid. ↑PMNs. ↑lymphocytes. ↑lymphocytes/ monocytes. Normal. Normal/↑. Normal/↑. Opalescent. Common causes of meningitis. N. meningitis. S. pneumoniae. Group B Strep. S. pneumoniae. GNRs. E. coli. N. meningitis. Enteroviruses.
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CSF findings in meningitis Turbid ↑PMNs ↑lymphocytes ↑lymphocytes/ monocytes Normal Normal/↑ Normal/↑ Opalescent
Common causes of meningitis N. meningitis S. pneumoniae Group B Strep S. pneumoniae GNRs E. coli N. meningitis Enteroviruses Listeria Listeria S. pneumoniae H. influenzae type B HSV Enteroviruses
Intracranial Hemorrhage Often secondary to fracture of temporal bone. Lucid interval. Rapid expansion under systemic arterial pressure -->transtentorial herniation, CNIII palsy Rupture of middle meningeal artery Delayed onset of s/s. Seen in elderly, alcoholics, blunt trauma, shaken baby. Rupture of bridging veins Rupture of aneurysm (usually Berry) “Worst headache of my life”
Huntington’s: autosomal dominant trinucleotide repeat disorder • chorea, aggression, depression, dementia • neuronal death via NMDA-R binding and glutamate toxicity • atrophy of striatal nuclei • caudate loses ACh and GABA
Parkinson’s: • degenerative disorder of CNS • Lewy bodies: α-synuclein (intracelluar inclusion) • depigmentation of substantia nigra pars compacta (loss of dopaminergic neurons • s/s: resting tremor, cogwheel rigidity, bradykinesia, postural instability
Multiple Sclerosis: • autoimmune inflammation and demyelination of CNS (brain & spinal cord) • pts can present w/ optic neuritis, MLF syndrome (internuclear ophthalmoplegia), hemiparesis, hemisory symptoms, bladder/bowel incontinence • relapsing & remitting course • Charcot’s triad of MS: scanning speech, intention tremor, nystagmus
Classification of Seizures Simple Partial Absence Neonatal Complex Partial Tonic-Clonic Infantile Spasms Tonic Partial w/ 2˚ Generalization Atonic Myoclonic
Foramen ovale: V3 • Foramen rotundum: V2 • Foramen spinosum: middle meningeal artery • Jugular foramen: IX, X, XI; jugular vein • Superior orbital fissure: III, IV, V1, VI, ophthalmic vein • Cribiform plate: 1 • Optic canal: II, ophthalmic artery, central retinal vein • Internal auditory meatus: VII, VIII • Hypoglossal canal: XII • Foramen magnum: spinal roots of XI, brain stem, vertebral arteries