Central Venous thrombosis
- Female predominance/postpartum/pregnancy/OCP/thrombophilia
- HA/stroke like symptoms/N/V/Encephalopathy
- Most common in sup.sag. sinus> transverse sinus> sigmoid sinus
- Cord sign https://radiopaedia.org/articles/cord-sign-dural-sinus-thrombosis
- Triangle sign https://radiopaedia.org/articles/empty-delta-sign-dural-venous-sinus-thrombosis?lang=us
- Heparin? Yes please. Then OAc
Guillain- Barre
- Autoimmune mediated polyradiculoneuropathy
- Ascending symmetric, bilateral weakness
- Red flags: bulbar weakness/resp. distress/autonomic instability
- Preceded by recent illness/vaccination
- IVIg or plasmapheresis
Acute dizziness
- Must differentiate between pre-syncope and dizziness
- Vertiginous: Acute vestibular syndrome, triggered episodic vestibular syndrome, spontaneous vestibular syndrome, vestibular neuritis, BPPV
- Dangerous Ds: diplopia, dysarthria, dysphonia, dysphagia, dysmetria > r/o CVA
- Do a HINTS exam: head impulse test, nystagmus, test of skew
- HINTS https://www.youtube.com/watch?v=1q-VTKPweuk
- Dix hallpiike https://www.youtube.com/watch?v=Ey7TlLJUErY&pp=0gcJCfwAo7VqN5tD
- Epley maneuver https://www.youtube.com/watch?v=F_2GpR4HtkY
Functional Neurologic Disorder
- Functional neurologic abnormality without evidence of structural abnormality
- Always rule out structural causes i.e. CVA
- Can see abnormalities on fMRI
- Involuntary is a key aspect, absence of conscious secondary gain
- Hoover sign