Neuroscience foundations, neurogenetics, neuroimaging, and critical care neurology
Neuroscience foundations, neurogenetics, neuroimaging, and critical care neurology
The exam tests neuroanatomy, genetic inheritance, imaging selection, and neurocritical care. Localize lesions by pathways: corticospinal weakness, dorsal column proprioception, spinothalamic pain/temperature, and cranial nerve nuclei. CT detects hemorrhage and mass effect; MRI with diffusion-weighted imaging detects early ischemia. Genetic patterns include autosomal dominant, autosomal recessive, X-linked, and mitochondrial inheritance. In neurocritical care, manage airway, blood pressure, intracranial pressure, seizures, and fever. Brain death requires irreversible coma, absent brainstem reflexes, and apnea testing.
Worked example
A 55-year-old has a large hemispheric infarct with declining consciousness and a blown pupil. Reasoning: impending herniation. Elevate the head, hyperventilate briefly, give hyperosmolar therapy, and obtain urgent neurosurgical evaluation.
Traps
Do not rely on early CT to exclude ischemic stroke; do not miss brainstem signs in coma; do not perform apnea testing without prerequisites; do not forget genetics in young stroke or familial neurodegeneration; do not treat increased ICP without confirming airway and hemodynamics.