Middle Cerebral Artery
- Contralateral paralysis upper limb and face
- Contralateral loss of sensation of upper limb and face
- Affects Wernicke's area and Broca's area
- Aphasia if Lesion in Dominant (Left) Hemisphere
- Hemineglect if lesion in nondominant (right) hemisphere
Anterior Cerebral Artery
- Contralateral paralysis of lower limb
- Contralateral loss of sensation in lower limb
Types of Strokes
- Transient Ischemic Attack (TIA)
- Reversible Ischemic Neurologic Deficit (RIND)
- Ischemic
- Thrombotic
- Atherosclerosis
- Embolic
- Atrial Fibrillation
- Hemorrhagic
- Severe Hypertension
Types of Head Injuries
- Open Head Injury
- Linear Fracture
- Comminuted Fracture
- Depressed Fracture
- Open Fracture
- Basilar Skull Fracture
- Closed Head Injury
- Coup and Contrecoup
- Brain Contusion
- Concussion
Traumatic Brain Injury Assessment
- Change in LOC
- Personality Changes
- Amnesia
- Increased Intracranial Pressure
- Diplopia
- Posturing
- Basilar Skull Fracture
- Halo or Ring Sign
- Intracranial Bleeding
Subarachnoid Hemorrhage
- Bleeding into Subarachnoid Space
- Trauma
- Aneurysm Rupture
- AVM Rupture
- Vasospasm causes Ischemia
- "Worst Headache Of My Life"
- Noncontrast Head CT
- Lumbar Puncture
- Angiography
- Surgery
- Blood Pressure Control
- Intracranial Pressure Control
- Nimodipine for Vasospasm Prophylaxis
Subdural Hematoma
- Tear of Bridging Veins
- Slow Bleeding, Over Time
- Subdural Space
- Crescent-shaped on CT
- Crosses Suture Lines
- Midline Shift
- Elderly
- Whiplash
- Abusive Head Trauma (Shaken Baby Syndrome)
Epidural Hematoma
- Middle Meningeal Artery Rupture
- Temporal Bone Fracture
- Hematoma Between Skull And Dura Mater
- Transtentorial Herniation
- Lucid Interval
- Lens-shaped on CT
- Does Not Cross Suture Lines
- Craniotomy
Left Hemisphere Stroke Assessment
- Opposite Side Weakness (Hemiplegia)
- Side to Side Discrimination
- Aphasia
- Agraphia
- Slow Performance
- Aware of Deficits
- Anxiety
- Depression
Right Hemisphere Stroke Assessment
- Opposite Side Weakness (Hemiplegia)
- Poor Proprioception
- Disoriented to Person, Place, Time
- Can't Recognize Faces (Prosopagnosia)
- Loss of Judgement and Awareness
- Impulsiveness
- Personality Changes
- Tonal Hearing Loss
Increased Intracranial Pressure (ICP) Assessment
- Change in LOC
- Headache
- Cushings Triad
- Irregular Respirations
- Widening Pulse Pressure
- Bradycardia
- Projectile Vomiting
- Abnormal Pupils
- Papilledema
- Posturing
Increased Intracranial Pressure (ICP) Interventions
- Elevate Head Of Bed
- Foley Catheter
- Mannitol (Osmitrol)
- High Dose Barbiturates
- Passive Hyperventilation
- Dexamethasone (Neoplasm or Infection)
- Neuro Assessment
- Maintain Normal Temperature
- Avoid Activities That Increase ICP
- Intracranial Monitoring System
Types of Seizures
- Tonic-Clonic
- Tonic
- Clonic
- Absence (Petit Mal)
- Myoclonic
- Atonic
- Partial (Focal) Seizure
- Focal Aware (Formerly Called Simple Partial)
- Focal Impaired Awareness (Formerly Called Complex Partial)
Tension Headache
- More Common in Women
- Bilateral Band-like Pain
- Occipital and Neck region
- Exacerbated by Stress
- Exacerbated by Fatigue
- > 30 Minutes
- Relaxation
- Caffeine
- NSAIDs
- Acetaminophen
- Amitriptyline
Cluster Headache
- More Common in Men
- Unilateral Periorbital Headache
- Ipsilateral Tearing
- Precipitated by Alcohol
- Stabbing Pain
- 15 min - 3 Hours
- Repetitive Attacks in Clusters
- High Flow 100% O2
- Ergots
- Sumatriptan
Alzheimer's Disease Assessment (Early Symptoms)
- Advanced Age
- Poor Judgment and Decision-Making
- Difficulty Having a Conversation
- Inability to Manage a Budget
- Losing Track of the Date or Season
- Misplacing Things
Alzheimer's Disease Assessment (Late Symptoms)
- Memory Impairment
- Wandering Behavior
- Confabulation
- Perseveration
- Lack of Abstract Thinking
- Severe Cognitive Decline
Alzheimer's Disease Interventions
- PET Scan and CT
- Mini-Mental State Examination
- Drug Therapy
- Safe Environment
- Moderate Exercise
- Behavioral Modification
- Assistance with Functional Independence
- Assistance and Support for Caregiver
Multiple Sclerosis Features and Mechanisms
- More Common in Women
- Presents in 20's and 30's
- Northern Europeans
- Unknown mechanism, genetic factor
- HLA-DRB1
- Autoimmune Demyelination of CNS
- White Matter of Brain and Spinal Cord
- T Cell Mediated Inflammation
Multiple Sclerosis Assessment
- Nerve Fiber Demyelination
- Motor Issues
- Cerebellar Signs
- Fatigue
- Paresthesias
- Spasticity
- Urinary Incontinence
- Optic Neuritis
- Women Between 20-50 Years Old
- Relapse and Remission of Symptoms
Multiple Sclerosis Symptoms and Diagnosis
- Optic Neuritis
- Internuclear Ophthalmoplegia
- Scanning Speech
- Urinary and Fecal Incontinence
- Motor Issues (Intention Tremor, Paresis)
- Numbness and Pain
- Depression
- Relapsing Symptoms
- Gold Standard = Plaques on MRI
- Increased CSF Immunoglobulins (IgG)
- Oligoclonal Bands
Multiple Sclerosis Interventions
- Corticosteroids
- Interferon Beta
- Dimethyl Fumarate (Tecfidera)
- Fingolimod (Gilenya)
- Mitoxantrone (Novantrone)
- Natalizumab (Tysabri)
- Increase Exercise
- Identify Triggers
Causes of Dementia
- Intoxication or Medications
- Depression
- Normal Pressure Hydrocephalus
- Vitamin B12 Deficiency
- Metabolic Conditions
- Lewy Body Dementia
- Prion Disease
- Pick's Disease
- AIDS Dementia
- Alzheimer's Disease
- Multi-infarct (Vascular) Dementia
Parkinson's Disease Assessment
- Decreased Dopamine
- Older Adult
- Cogwheel Rigidity
- Bradykinesia
- Shuffling Gait
- Resting Tremor
- Pill-Rolling
- Mask-Like Face
- Cognitive Decline
Parkinson's Disease Interventions
- Levodopa/Carbidopa (Sinemet)
- Entacapone (Comtan)
- Selegiline (Eldepryl)
- Amantadine (Symmetrel)
- Bromocriptine (Parlodel)
- Benztropine (Cogentin)
- Allow Extra Time
- Ensure Patient Safety
- Surgery As Last Resort
Parkinson's Drugs
- Decreased Dopamine
- Increased Acetylcholine
- BALSA Acronym
- Bromocriptine
- Amantadine
- Levodopa
- Selegiline
- Antimuscarinics
Guillain-Barre Syndrome Assessment
- Ascending Paralysis
- Muscle Weakness
- Paresthesias (Pins and Needles)
- Diplopia
- Difficulty Speaking
- Dysphagia
- Labile Blood Pressure
- Loss of Bowel and Bladder Control
- Aggressive Airway Management