🧠Cerebrum🧠
List the possible neurologic deficits see in in a pt with a lateralized cerebral lesion
biggest is mentation. behavior changes, head turn and circling (ipsilateral), menance def. Ipsi. abnormal nasal sensation.
postural reactions-contraleral.
List the expected neurologic deficits for a pt with a brainstem lesion
alterations in level of consciousness, head tilt (ipsilateral, unless paradoxical), proprioceptive ataxia, and or vestibular ataxia. CN multiple possible. postural deficits ipsilateral. spinal reflexes and tone normal or increased in all four limbs
Know the common clinical signs of vestibular diseases
Head tilt, ataxia, circling, nystagmus, strabismus
head tilt-most common sign, toward the lesion
ataxis-hallmark is asymmetry.
circling toward the lesion is present
pathologic nystagmus-spontaneous or positional, slow and fast phase. fast away from lesion.
clinical signs of vestibular dx
feline panleuk causes?
cerebellar hypoplasia
so cerebellar not forming correctly. diagnosis mri and signs. no tx
id the causes and tx for hydrocephalous
congenital causes:
obstruction of flow of CSF:
decreased absorption
increased production
acquired hydrocephalous can occur secondary to inflammation causing decreased absorption
signs slow learners, dome shaped head
TX: medical management-directed at decreasing CSF production: prednisone and omeprazole. SX for medically non-responsive cases
describe the diagnostics, tx, and prognosis for patients with MUE
gme mostly affects? clinical signs test
NLE effects? and area affected?
MUE-meningoencephalitis of unknown etiology. HAS GMA, NME and NLE in it
GME small breed dogs, peak age 4-8 years signs: pain, seizures, and cerebellovestibular dysfunction are most common. histopathology is the only definitive test. look for perivascular infiltrates, granulomatous inflammation diagnosis-MRI variable, csf TX-nothing defined. steroids, immunomodulatory, radiation
yorkies, similar to NME. necrotizing encephalitis of yorkies. effects white matter in cerebrum and brainstem
TX for MUE and this is pred and immmunomodulatory medications. goal of tx is to tirate to effect. prognosis for mue is not yr and change. poor without therapy
know how to distinguish the clinical signs of peripheral versus central vestibular dx
peripheral-CN 7, horners, no pain
central-delayed to absent postural reactions. ipsilateral. CN III-XII, +/- UMN. and altered mentation
diagnostic testing
min database, advance imaging, csf, titers, bipsy fungal
steroid responsive tremor syndrome
signs diag, tx
tremors cons. csf analyiss, tx steroids
This is an age related syndrome like Alzheimer's in people. pathophysiology is unknown. Clinical signs: older pts (dogs >9yrs, and cats >12) non specific signs-inattentive, inactivity, aimless, wandering, demented, changes to sleep/wake cycles incontinence.
diagnosis is made based on clinical signs and MRI, there is no tx, aim is to improve function
Canine cognitive dysfunction syndrome CDS
explain the importance of maintaining intracranial pressure
With elevated ICP get decrease cPP then ischemia and energy failure and cell swelling. leads to secondary injury CPP(cerebral perfusion pressure)
CPP=map -icp
with increased ICP get cushings reflex where get bradycardia, decreasing blood flow to brain=ischemia
then more increased icp =herniation
diagnosis-ear exam, imaging
tx antibiotics no topical. may require sx
ischemic vs hemorragic stroke
diagnostic test for a stroke
ischemic-clot blocks blood flow to an area of the brain
hemorrhagic-bleeding occurs inside or aroudn the brain tissue. signs frmo compression of surrounding tissue. from spontaneous vessel rupture, intracerebral hemorrage, hemoatoma formation
diganostics hemo-mri. others BP key, min database, fundic, ab us, thoracic rads
location of infarctions
cerebellar and forebrain
this is caused by a build of neurotoxins. clinical signs: median age at diagnosis 12 months. obtunded, abnormal behavior, head pressing, visual deficits and rarely sx
hepatic encephalopathy
pseudofunction tests decreased.
diagnosed: us, mri, ct, scintagraphy
medical dx neurotoxins, decrease sxs
T/F glucocorticoids are not recommended with head trauma
true but mannitol and hyperoxygenation are, and +/- anticonvulsants
diagnostics tests for pt with vestibular dx
peripheral-otoscopic exam, oropharyngeal exam, cbc, ct, mri, ear cytology, ventral bulla osteotomy, electrodiagnostics
central-mri always perferred, csf analaysis, serum and CSF titers, bioospy, fundic exam, clotting,
cerebellar cortical degeneration is
atrophy of the cerebellum over life, mostly in purebred dogs. 3-12 months. diagnosis imaging genetic tx none
These are the most common viral infectious causes that infect the cerebrum
these are the categories of immune mediated dxs.
canine distemper virus, feline infectious peritonitis
steroid responsive meningitis arteritis (SRMA). then other is meningoencephalitis of unknown etiology (MUE) with granulomatous meningoencephalitis (GME) in one box. then also necrotizing encephalitis with two types one meningoencephalitis and other is leukoencephalitis.
what is idiopathic vestibular dx
per-acute symptoms, non progressive, older dogs (>5 years) diagnossis of exclusion
ataxia head tilt, strabismus, rapid nystagmus, no def test. tx time and supportive care. antiemetics, iv fluids, sedation. prognosis good
difference between caudal occipital malformation syndrome vs springomyelia
first is too small occipital bone so cerebellum is squeezing out there
sytin-cavity within the spinal cord filled with fluid, can be due to above.
signalment young dogs, cavalier king charles spanieal,
dx mri.
tx medical analgesic, decrease csf, pred key. can do sx as well. both options work