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21 Cards in this Set

  • Front
  • Back
What does the brain look like in cerebral edema?
Gyri are flattened out and the brain looks like it has a smooth contour
What are the 2 types of cerebral edema?
Vasogenic or Cytotoxic
What causes vasogenic cerebral edema?
Increased vascular permeability so that fluid shifts into intracellular spaces in the brain. Could be caused by Reye's syndrome
What causes cytotoxic cerebral edema?
Caused by cell membrane injury, where cell bodies themselves swell, not the vessels. Seen in hypoxia or with metabolic damage
What is the drug treatment of choice for cerebral edema?
Mannitol, it is an osmotic diuretic and is a small sugar that does not cross the BBB, the osmotic force pulls water across membranes through aquaporins
What causes hydrocephalus?
CSF is normally reabsorbed in brain vessicles through arachnoid granulations and brought into the sagital sinus. When there is a block in circulation of CSF, the fluid backs up and causes hydrocephalus
What are the 5 types of hydrocephalus?
1.) Communicating
2.) Non-communicating
3.) Ex vacuo
4.) Increased CSF production
5.) Normal pressure
What is non-communicating hydrocephalus?
When there is a block in a specific ventricle in the system, so that only part of the ventricular system is enlarged. Caused by congenital malformations, neoplasms, inflammatory processes, and hemorrhages
What is communicating hydrocephalus?
Block in the subarachnoid space so that the CSF can't get thru the arachnoid granulations and the entire ventricular system is enlarged. Caused by meningitis when the brain has a lot of pus on it
What is hydrocephalus ex vacuo?
When there is no block in the ventricular system, but is due to brain atrophy where then the body over compensates and produces CSF. Essentially, ventricles get bigger as rest of brain tissue shrinks. Caused by Alzheimer, pick disease, and massive hypoxic episode
What is hydrocephalus due to increased CSF?
Uncommon could be caused by choroid plexus papilloma, a benign tumor
What is normal pressure hydrocephalus?
Seen in elderly patients with gait disturbance, urinary incontinence, and dementia. They have large ventricles with no cortical atrophy, thought to maybe be a form of communicating hydrocephalus, symptoms are often reversible, but it is usually misdiagnosed as AD.
What are the goals of treating hydrocephalus?
Get the fluid out (surgery to remove block or shunt to redirect CSF drainage) and decrease CSF production (pharmacology)
What drug decreases CSF production as a carbonic anhydrase inhibitor
Acetazolamide
How does furosemide work to decrease CSF production?
It is a Na K 2Cl pump inhibitor
What are the symptoms of herniation?
Headache, vomiting, decreased level of consciousness, papilledema (optic disc gets swollen)
Often fatal
What are the causes of herniation?
Unilateral space occupying lesions or diffuse lesions
What are the types of herniation (3 of them)?
1.) subfalcine (cingulate)
2.) trantentorial (uncinate)
3.) tonsillar
What causes subfalcine/cingulate herniations? What are the symptoms?
Expansion of one hemisphere displaces cingulate gyrus under the falx cerebri. Causes compression of branches of anterior cerebral artery which can lead to weakness of limbs, aphasia, etc.
What causes transtentorial/uncinate herniations? What are they symptoms?
Temporal lobe is compressed against tentorium, affecting the third cranial nerve, brainstem, posterior cerebral artery, and contralateral cerebral peduncle which can cause hemiparesis. Tentorium is pushing on the brain
What causes tonsillar herniation? What are the symptoms?
Displacement of the cerebellar tonsils through the foramen magnum. Compresses medulla, compromising vital respiratory and cardiac centers, and is LIFE-THREATENING!