PAEA Neurology 2- Questions and Answers|
Latest Update
What type of lesion produces an ipsilateral motor disturbance and impairment of proprioception;
the lesion also produces a contralateral loss of pain and temperature sensation below the lesion
Unilateral cord lesion
(Brown sequard syndrome)
What type of lesion may lead to a lower motor neuron deficit and loss of pain and temperature
sensation with sparing of the posterior column functions Central cord syndrome
Tx for spinal cord injury immobilization as well as decompressive laminectomy and
fusion if there is cord compression
Early tx w high dose corticosteroids has been shown to improve neurologic recovery if started
within 8 hours of injury
Anatomic realignment of spinal cord by traction
1/2 of all primary intracranial neoplasms are... gliomas
10% of spinal tumors are intramedullary, which of them is most common? ependymoma
,MC sources of intracranial metastasis are.... carcinoma of the lung, breast, kidney and GI
tract
What type of neoplasm produces progressive intellectual decline, slowing of mental activity,
personality changes, contralateral grasp reflexes and possibly expressive aphasia? Frontal
lobe lesion
What type of neoplasm leads to seizures, olfactory or gustatory hallucinations, licking or
smacking of the lips depersonalization, emotional and behavioral changes, visual field defects
and auditory illusions? Temporal lobe lesion
Which type of neoplasm causes contralateral disturbances of sensation and may cause sensory
seizures, a cortical sensory loss (impaired stereognosis) or inattention, or some combo of these?
Parietal lobe lesion
Which type of neoplasm causes crossed homonymous hemianopia or a partial field defect, visual
agnosia for objects and colors or unformed visual hallucinations? Occipital lobe lesion
Which neoplasm produces cranial nerve palsies, ataxia, incoordination, nystagmus, and
pyramidal and sensory deficits in the limbs on one or both sides? Brain stem and
cerebellar lesion
Diagnostic studies for neoplasms Head CT or MRI w contrast - detects lesion, location,
size, and degree of cerebral edema or mass effect
, Arteriography - stretching or displacement of normal cerebral vessels as well as the presence of
tumor vascularity
EEG - focal disturbance
CT myelography or MRI of the spine - may be needed to identify the site of spinal cord
compression
CSF removed at myelography often is xanthochromic and contains greatly increased protein
concentration, normal cell content, and normal glucose concentration
Treatment for neoplasms Complete surgical removal of the tumor may be possible if it is
extra-axial or not in a critical or inaccessible region of the brain
Surgical shunting of an obstructive hydrocephalus
Radiation, chemo or both
Corticosteroids - help to reduce cerebral edema and usually are started before surgery
Anticonvulsants
Intramedullary cord lesions are treated by decompression and surgical excision and irradiation
Latest Update
What type of lesion produces an ipsilateral motor disturbance and impairment of proprioception;
the lesion also produces a contralateral loss of pain and temperature sensation below the lesion
Unilateral cord lesion
(Brown sequard syndrome)
What type of lesion may lead to a lower motor neuron deficit and loss of pain and temperature
sensation with sparing of the posterior column functions Central cord syndrome
Tx for spinal cord injury immobilization as well as decompressive laminectomy and
fusion if there is cord compression
Early tx w high dose corticosteroids has been shown to improve neurologic recovery if started
within 8 hours of injury
Anatomic realignment of spinal cord by traction
1/2 of all primary intracranial neoplasms are... gliomas
10% of spinal tumors are intramedullary, which of them is most common? ependymoma
,MC sources of intracranial metastasis are.... carcinoma of the lung, breast, kidney and GI
tract
What type of neoplasm produces progressive intellectual decline, slowing of mental activity,
personality changes, contralateral grasp reflexes and possibly expressive aphasia? Frontal
lobe lesion
What type of neoplasm leads to seizures, olfactory or gustatory hallucinations, licking or
smacking of the lips depersonalization, emotional and behavioral changes, visual field defects
and auditory illusions? Temporal lobe lesion
Which type of neoplasm causes contralateral disturbances of sensation and may cause sensory
seizures, a cortical sensory loss (impaired stereognosis) or inattention, or some combo of these?
Parietal lobe lesion
Which type of neoplasm causes crossed homonymous hemianopia or a partial field defect, visual
agnosia for objects and colors or unformed visual hallucinations? Occipital lobe lesion
Which neoplasm produces cranial nerve palsies, ataxia, incoordination, nystagmus, and
pyramidal and sensory deficits in the limbs on one or both sides? Brain stem and
cerebellar lesion
Diagnostic studies for neoplasms Head CT or MRI w contrast - detects lesion, location,
size, and degree of cerebral edema or mass effect
, Arteriography - stretching or displacement of normal cerebral vessels as well as the presence of
tumor vascularity
EEG - focal disturbance
CT myelography or MRI of the spine - may be needed to identify the site of spinal cord
compression
CSF removed at myelography often is xanthochromic and contains greatly increased protein
concentration, normal cell content, and normal glucose concentration
Treatment for neoplasms Complete surgical removal of the tumor may be possible if it is
extra-axial or not in a critical or inaccessible region of the brain
Surgical shunting of an obstructive hydrocephalus
Radiation, chemo or both
Corticosteroids - help to reduce cerebral edema and usually are started before surgery
Anticonvulsants
Intramedullary cord lesions are treated by decompression and surgical excision and irradiation
