Head Injury: Subdural Haematoma, Skull Fractures and Contusions
Remember: CSDH can occur in the elderly in the context of minimal trauma to head. Associations/Risk Factors Apart from blunt trauma and age >60 years, risk factors for CSDH include…
Myasthenia Gravis and Lambert–Eaton Myasthenic Syndrome
Remember the association between MG and thymus gland disorders. Pathology/Pathogenesis MG is mediated by antibodies (IgG) directed against the acetylcholine receptor (AchR) found on the postsynaptic membrane at the NMJ….
Spinal Injuries and Spinal Cord Syndromes
Remember the association between head injury and cervical spine injury and therefore the need to immobilise and log-roll these patients, until spinal injury is excluded clinically and/or radiologically as appropriate….
Stroke II: Intracerebral Haemorrhage
Remember: CT head is the initial diagnostic investigation of choice in ICH. Routine blood tests FBC (including platelet count), U & E (check for evidence of end organ damage related…
Transient Ischaemic Attacks (TIAs)
Carotid Doppler ultrasound: Detects narrowing using blood flow velocity and may identify plaque features reflecting risk. Limited by calcification and arterial anatomy. CT angiography (CTA) and contrast MR angiography (MRA):…
Diseases of the Muscle
Onset in males at 3–5 years Mainly affects axial and proximal muscles (difficulty in walking with waddling gait, Gower’s manoeuvrea and pseudo-hypertrophy of gastrocnemius) Low IQ in up to 30%…
Hydrocephalus
Remember: Presentation of these patients is varied—patients or their parents/carers are often right when they suspect VP shunt blockage—ignore them at your peril. Infants: Abnormal head growth with ‘crossing centiles’…
Radiculopathy and Disc Herniation
Remember: In lumbar spine, a herniated lumbar disc usually compresses the nerve root exiting from the foramen below the level of herniation; therefore, an L5/S1 disc prolapse will impinge upon…
Numbness and Sensory Disturbance
Useful Selected Questions to Ask/Facts to Establish? Establish the character of the sensory disturbance (e.g. an absence of sensation (numbness), an uncomfortable sensation (dysaesthesia) or a burning or painful sensation)….
