Neurologic Diseases and Treatment

Study Notes

Vascular Compression

Traumatic ischemic and hemorrhagic strokes can occur due to accidental head trauma, with a reported risk of 2.2% in infants.
Subdural hematomas in children result from the stretching of meningeal vessels, often linked to accidental trauma.
Performing craniotomy for decompressive purposes is a predictor of cerebral infarction.

Infection

Bacterial meningitis can lead to disseminated intravascular coagulation (DIC), vascular inflammation, and thrombosis, resulting in arterial or venous infarction.
Cerebral vasculopathy complications from meningitis may include vasculitis, vasospasm, aneurysm formation, and, rarely, subarachnoid hemorrhage.
Group B streptococcal meningitis is a notable cause of stroke in newborns, transmitted from mother to infant or through nursing staff.
Infants are prone to infections from maternal flora or environmental bacteria, particularly Group B streptococci, gram-negative bacilli, and Listeria monocytogenes.
After two months, Streptococcus pneumoniae and Neisseria meningitides become prevalent causes of bacterial meningitis.
Vaccination against Haemophilus influenzae type b at two months has significantly decreased the incidence of H. influenzae-b meningitis.
Immunocompromised individuals, such as those with cancer or AIDS, are at risk for meningitis caused by Aspergillus species, leading to vasculitis and infarction.
In patients with HIV/AIDS, a variety of ischemic and hemorrhagic stroke causes are present, including marantic endocarditis and arteriopathy of small and medium vessels.

Vascular Malformations/Vasculopathy/Migraine/Anatomical Variation

Vascular malformations may lead to intracerebral hemorrhage, where resulting vasospasm can provoke ischemic infarctions.
Jorgen-artery stenosis commonly occurs in healthy children who experience arterial ischemic strokes.
Approximately 10% of hemorrhagic strokes and most subarachnoid hemorrhages in children are due to ruptured aneurysms.
Moyamoya disease, a rare and progressive steno-occlusive vasculopathy, is associated with abnormal vascular formation resembling a "puff of smoke" and affects the distal supraclinoid internal carotid artery and proximal middle cerebral artery.
The underlying mechanism of moyamoya disease remains unknown, but it has a high prevalence in Japan, Korea, and China.
This condition typically presents bimodally in children under 10-15 years and in adults during their 30s to 50s, with a higher occurrence in females among children.
Pediatric symptoms may include transient ischemic attacks, strokes, headaches, seizures, and movement disorders; adults may present with intracranial hemorrhages such as subarachnoid or intraventricular hemorrhages.
Some moyamoya patients may develop brain aneurysms.
Fibromuscular dysplasia (FMD) is related to moyamoya and is characterized by segmental vascular issues leading to stenosis, occlusion, aneurysms, or dissections.

Description

Explore the various aspects of neurologic diseases and their treatments. This quiz covers topics such as vascular compression, traumatic strokes, and the impact of infections like bacterial meningitis. Test your knowledge on crucial diagnostic and therapeutic approaches in neurology.