Neurological Disorders II

What are the Types of head injury?

Primary and Secondary

What is Shaken Baby Syndrome?

A condition resulting from violent shaking of an infant, leading to severe brain injury.

What is a Coup injury?

An injury occurring at the site of impact to the head.

What is a Contrecoup injury?

An injury occurring on the opposite side of the impact to the head.

What is Concussion?

A type of traumatic brain injury caused by a blow to the head or body that causes the brain to move rapidly back and forth.

What is a Contusion?

A bruise on the brain caused by a direct impact.

What are Hematomas?

Localized collections of blood outside of blood vessels, classified as subdural, epidural, or intracerebral.

What are CNS Infections?

Infectious processes that occur in the central nervous system.

What is a Cerebrovascular accident (CVA)?

A medical emergency that occurs when blood flow to the brain is interrupted.

What is Ischemic stroke?

A type of stroke that occurs when a blood vessel supplying blood to the brain is obstructed.

What is a Hemorrhagic stroke?

A type of stroke that occurs when a blood vessel in the brain bursts.

What is a Transient Ischemic Attack (TIA)?

A temporary period of symptoms similar to those of a stroke.

What is are Cerebral aneurysms?

An abnormal bulge in the wall of a blood vessel in the brain.

What are Headaches?

Pain in the head, with types including tension, cluster, and migraines.

What are Migraine headaches?

Severe, recurring headaches often accompanied by nausea and sensitivity to light.

What is CGRP?

Calcitonin Gene-Related Peptide, a neuropeptide involved in the pathophysiology of migraines.

What are Triptans?

A class of medications used to treat migraines by acting as agonists of serotonin receptors.

What are Seizures?

Sudden, uncontrolled electrical disturbances in the brain that can cause changes in behavior, movements, feelings, and consciousness.

What is Epilepsy?

A neurological disorder characterized by recurrent seizures.

What is a Convulsion?

A sudden, violent, irregular movement of the body, often associated with a seizure.

What is Photic stimulation?

A method used to induce seizures in susceptible individuals through flashing lights.

What is a Tonic?

A phase of a seizure characterized by muscle stiffness.

What is a Clonic?

A phase of a seizure characterized by rhythmic jerking movements.

What is a Head injury?

Traumatic brain injury: Structural damage of skull and/or brain.

What are Primary injuries?

Damage caused by impact at the time of injury.

What are Secondary injuries?

Occurs later; damage results from subsequent brain swelling, infection, cerebral hypoxia, often diffuse or multifocal.

What are the Signs of brain injury?

Signs of ↑ICP, seizures, cranial nerve impairment, leaking of CSF or blood from ear or nose, fever, stress ulcers.

What is a Coup?

Direct contusion of the brain at the site of external force.

What is a Contrecoup?

Rebound injury on the opposite side of the brain.

What are the Signs of Shaken Baby Syndrome?

Retinal hemorrhage, broken bones (especially of the cervical vertebrae), palliedema.

What is Postconcussion syndrome?

Mild symptoms may persist for months: headache, irritability, insomnia, poor concentration and memory.

What is Cerebral Laceration?

Tears in brain tissue resulting from penetrating brain injuries, possibly caused by foreign objects or bone fragments.

What is Epidural hematoma?

Type of hematoma resulting from vascular injury.

What is Subdural hematoma?

Type of hematoma resulting from vascular injury.

Whta is Intracerebral hematoma?

Type of hematoma resulting from vascular injury.

What is Meningitis?

Infection of the meninges.

What is Encephalitis?

Infection of the brain parenchyma.

What is Myelitis?

Infection of the spinal cord.

What is Encephalomyelitis?

Infection of both the brain and spinal cord.

What is a Cerebrovascular Accident?

Infarction of brain tissue that results from lack of blood.

What is Tissue necrosis?

Death of tissue due to lack of blood supply.

What is Ischemia?

Lack of blood flow, ≤5 min can cause irreversible cell damage.

What is a Stroke Progression?

A central area of necrosis develops, followed by inflammation, edema, and increased intracranial pressure (↑ICP).

What the Stroke Signs and Symptoms?

Sudden weakness, numbness, or tingling in face, arms, legs; loss of speech; confusion; sudden loss of vision; severe headache; dizziness.

What is Thrombus?

A blood clot that forms in a blood vessel.

What is the Embolus?

A blood clot that travels through the bloodstream.

What are the Risk Factors for Ischemic Strokes?

Diabetes, hypertension (HTN), high cholesterol, atherosclerosis, history of TIAs or prior strokes, advanced age, heart disease, smoking, oral contraceptives.

What is Thrombotic Stroke?

A type of ischemic stroke caused by a blood clot forming in an artery supplying blood to the brain.

What are Lacunar Infarcts?

Small, deep brain infarcts caused by occlusion of small penetrating arteries.

What are Embolic Stroke?

A type of ischemic stroke caused by a blood clot that forms away from the brain and travels to a cerebral artery.

What are Transient Ischemia Attacks (TIAs)?

Temporary localized decrease in brain blood flow that reverses before infarction can occur.

What is TIA Recovery?

Recovery occurs within 24 hours.

What are TIA Symptoms?

Depend on the location of the ischemia; may include muscle weakness, visual disturbances, numbness, aphasia, and confusion.

What is TIA Duration?

Symptoms may last a few minutes, but no longer than 1 - 2 hours.

What are Hemorrhagic Strokes?

Caused by bleeding into brain tissue, usually from a blood vessel rupture.

What is the Cerebral Aneurysms Location?

Occur at the points of bifurcation on the circle of Willis.

What is the Cerebral Aneurysms Initial State?

Initially small and asymptomatic.

What is Cerebral Aneurysms Progression?

Enlarge over the years and may rupture.

What are Cerebral Aneurysms Symptoms?

Loss of visual fields, headache, seizures, loss of consciousness, death.

What is Cerebral Aneurysms Treatment?

Surgery.

What are the Types of Headaches?

Tension, Cluster, Migraine.

What is a Tension Headache?

Most common type, does not usually interfere with daily activities, dull aching and diffuse.

What is a Cluster Headache?

Uncommon, neurovascular headache with severe unilateral pain, usually only behind one eye.

What are Cluster Headache Episodes?

1-8 headaches per day lasting 15-180 minutes; bouts may last days to months.

Migraines Prevalence?

Affect 38 million in the US alone.

Migraines Gender Prevalence?

Women are more affected than men, usually coincide with menses.

Migraines Etiology?

Unknown, may have a genetic component.

What is the Mechanism of Migraines?

Activation of trigeminal nerve leads to neural hyper excitability and cortical spreading depression.

What are the Neuropeptides in Migraines?

Substance P, Neurokinin A, Nitric oxide (NO), Calcitonin gene related peptide (CGRP), Pituitary adenylate-cyclase activating peptide (PACAP).

What is the function of CGRP?

Potent vasodilator and releases histamine from mast cells, leading to neurogenic inflammation.

What are the CGRP Release Sources?

sensory nerves, immune cells, endothelial cells, and adipocytes.

What are the Migraine Phases?

1. Prodrome, 2. Aura, 3. Headache (pain), 4. Postdrome.

What are the Categories of Migraines?

Migraines without aura (most common) and migraines with aura.

What are the Migraine Symptoms?

Headache usually is pulsatile, throbbing, unilateral, lasts 1-2 days, accompanied by nausea, vomiting, photophobia, and phonophobia.

What are Migraines with Aura?

Have similar symptoms as migraines without aura, but include visual disturbances, increased sensitivity to smells, and sensory disturbances.

How does a Migraine Headache feel?

Throbbing, pulsating

What is the Intensity of Tension Headache?

Mild to moderate

What is the Intensity of Migraine Headache?

Moderate to severe

What is the Intensity of Cluster Headache?

Excruciating, very severe

What is the Location of Tension Headache?

Bilateral, often across forehead, temples, or back of head

What is Location of Migraine Headache?

Usually unilateral, can be bilateral; commonly frontotemporal

What is the Location of Cluster Headache?

Strictly unilateral, usually around the eye or temple

What is the Duration of Tension Headache?

30 minutes to several hours; may persist for days

What is the Duration of a Migraine Headache?

4-72 hours (if untreated)

What is the Duration of Cluster Headache?

15 minutes to 3 hours

What is the Frequency of Tension Headache?

Variable

What is the Frequency of Migraine Headache?

Episodic=

What is the Frequency of Cluster Headache?

Up to 8 per day during a cluster period; occur in "bouts" lasting weeks to months

What are the Associated Symptoms of Tension Headache?

Usually none; sometimes mild sensitivity to light or sound

What are the Associated Symptoms of Migraine Headache?

Nausea, vomiting, photophobia, phonophobia

What are the Associated Symptoms of Cluster Headache?

Ipsilateral autonomic symptoms: tearing, nasal congestion, rhinorrhea, eyelid edema, miosis, ptosis

What is the Aura in Tension Headache?

Absent

What is the Aura in Migraine Headache?

Absent

What is the Aura in Cluster Headache?

Present in ~25% of cases (visual disturbances, sensory changes, speech issues)

What are the Triggers for Tension Headache?

Stress, fatigue, poor posture

What are the Triggers for Migraine Headache?

Alcohol, strong odors, napping, seasonal changes

What are the Triggers for Cluster Headache?

Stress, certain foods (chocolate, aged cheese), alcohol, hormonal changes, lack of sleep, bright lights, strong odors

What is the Cause (Pathophysiology) of Tension Headache?

Muscle tension, stress, poor posture

What is the Cause (Pathophysiology) of Migraine Headache?

Hypothalamic dysfunction leading to activation of trigeminal-autonomic reflex

What is the Cause (Pathophysiology) of Cluster Headache?

Neurovascular dysfunction involving trigeminovascular system, cortical spreading depression, Low serotonin