Neurology Clinical Cases Quiz

Human Body and Mind: Integration and Control Systems

• Neuro Leap: This is a course in integration and control systems within the human body.
• Learning Objectives: Students are expected to learn about various neurological conditions, including herniation, aphasia, seizures, and dementia, along with cranial neuropathies, ruptured aneurysms, migraines, visual field defects, corticospinal and corticobulbar tracts, and weakness patterns.
• Station 1: Anti-Herniation
  • Case Study: A 20-year-old male from Marinduque with a history of tuberculosis and recent seizure, showing decreased consciousness.
  • Symptoms: Headaches, sudden decrease in consciousness, decorticate posturing, nonreactive pupils, slow corneal reflexes, and weak gag reflex.
  • Tasks: Arrange brain stem slices from most rostral to caudal, photograph, and identify corticospinal tract and medial lemniscus pathways.
• Station 2: Black Box
  • Case Study: A 62-year-old female with decreased consciousness, minimal extremity movement, and moans when called.
  • Symptoms: Recent onset of decreased consciousness, moans to pain, inconsistent following commands, ptosis (drooping) of both eyes, right-sided facial palsy, sluggish right-sided corneal reflexes, and spontaneous right-sided extremity movement.
  • Tasks: Arrange brain stem slices from most rostral to caudal, photograph, and identify corticospinal tract and medial lemniscus pathways.
• Station 3: In Pain in the Membrane
  • Case Study: A 22-year-old male patient after a vehicle accident with loss of consciousness, with epistaxis, headaches.
  • Symptoms: No eye opening to pain, no verbal output, localizes to pain, pupils 2 mm isocoric, briskly reactive to light, intact dolls, intact corneals, intact gag, and withdrawal to pain, right-sided weakness, and clonus (sustained muscle spasms) on the left side.
  • Imaging: Epidural hematoma or hemorrhage.
  • Tasks: Use imaging to identify the cause of the patient's neurological deficits and use the relevant rule of 4's.
• Station 4: Malformation
  • Case Study: 29-year-old female with no verbal output, history of vomiting, and right-sided weakness.
  • Symptoms: No verbal output, follows commands, blood pressure at 120/80, pupils 2 mm isocoric, reactive to light, right shallow nasolabial fold, MMT findings (+), sustained clonus on the right.
  • Interpretation: Probable acute intracerebral hemorrhage (ICH) from Middle Cerebral Artery (MCA) rupture, with resulting left-sided hemiparesis and aphasia.
• Station 5: Space Occupying lesions
  • Case Study: 59-year-old female with headaches, occasional seizures, and left-sided headache.
  • Symptoms: Headache, occasional seizures (blank stares, eye rolling, generalized tonic-clonic seizures), and right-sided weakness.
  • Interpretation: Probable space-occupying lesion (SOL) in the left hemisphere, potentially a tumor likely with increased intracranial pressure and irritation of the surrounding tissues.
• Station 6: BE FAST
  • Specimen: Coronal sliced cerebrum
  • Tasks: Examine imaging and identify arterial territories.
• Station 7: Demyintindihan: OGK
  • Specimen: Dissected cerebral white matter, hemisphere with corpus callosum
  • Case Study: 46-year-old female with right lower extremity weakness.
  • Symptoms: Blurring of vision (right eye) leading to blindness, new ascending numbness and weakness in bilateral lower extremities, and subsequent progressive numbness and right lower extremity weakness.
  • Interpretation: Suspected Multiple Sclerosis (MS).
• Station 8: Decuss8
  • Specimen: Half brains (hemispheres)
  • Case Study: 74-year-old female with left-sided facial drooping.
  • Symptoms: Sudden-onset left-sided facial drooping and left-sided weakness following atrial fibrillation.
• Station 9: Time is Brain
  • Specimen: Model brain that can be taken apart into 9 pieces.
  • Tasks: Identify specific brain structures
• Station 10: Dis/Cord
  • Specimen: Uncut brain with spinal cord up to cauda equina.
  • Case Study: 48-year-old female with difficulty ambulating and decreased sensation.
  • Findings: Flaccid paralysis of right lower extremity, sensory deficit (pain/temperature) on right lower extremity, sensory deficit (proprioception) on left lower extremity. Possible Brown-Séquard lesion (hemisection of spinal cord).
• Vitamin D in Neurology: Vitamin D plays a role in maintaining neuronal health, regulating brain development, and function (antioxidant properties and calcium homeostasis).