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41 Cards in this Set
- Front
- Back
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a bleed in the brain will lead to hyper or hypo tensino?
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hypertension
cant bleed out into the brain not enough room |
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what is the stage of compensation?
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increased pressure in one area is compensated by decreased pressure elsewhere in the brain.
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brain edam causes
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cytotoxic, vasogenic, perineoplastic, inflammatory
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how do u treat brain edema?
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diuretics-mannitol, furosemide, hypertonic saline
steroids if inflammation |
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what compartments in the brain can be swollen to increase pressure in the others
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brain tissue
vascular CSF MASS lesion |
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what causes vascular swelling?
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vasodioation from increase pCO2
drugs loss of autoregulaion venous outflow obsturcion |
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CSF compartment swelling
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hydrocephalus, obstuctive or communication
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how do u treat vascular swelling in the brain
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elevate head of bed to releive venous compression
hyperventilation to reduce CO2 |
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elevating pressure in the head does what to CSF?
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does not reduce CSF production
CSF will contine to be produced reguardless of intracranial pressure |
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what is the first defense if cerebral blood flow is low?
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increase extraction of O2 from the blood
at normal WAY MORE FLOW THAN BRAIN NEEDS |
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at what level of CBF do u see EEG changes?
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below 25
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at what level of CBF is there reversible dysfunction?
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20
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what level is CBF considered infarction?
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15mins of no blood blow
but for long periods of time infarction occurs right below 20 |
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if there is brain dysfuncition seen and it is thought to be the result of reduce CBF what does that mean?
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no matter what level the CBF below 20 this patient is close to infaction
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what is the vicious cycle of edem and infarction?
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edema leads to ICP which leads to decreased ceberebral perfusion pressure, which leads to infarction, which lead to more edema
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what is the progression of supratentorial increased pressure due to progressive rostral caudal decay(IE like a sudural hematoma)
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focal distortion only effacement of local sulci and gyri
compression of lateral ventricles midline shift, subfalcial herniation temporal lobe herniation obliteration of basal CSF cistern third never compression |
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what causes duret hemorrhates?
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midbrain infarction
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what is the difference between single eye pupil dilation and both eye dilation?
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1- third nerve compression
both- midbrain infarction |
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what is progression of supratentorial increase pressure due to progressive rostral caudal decay(IE like a sudural hematoma) as far as symptoms go?
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headache-intracranial pressure
contralateral weakness-cortex single eye dilation- third nerve bilateral pupil- midbrain loss of flexor responses-midbrain flacciditiy-medulla respiratory issues-medulla increased sysolic pressure and bradycardia-medulla |
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what is medullary compresion syndrome
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respriatotory reflexes
shane stokes breathing cushing reflex- increased pressure and slower HR |
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what is focal mass effect?
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progressive rostratal caudal decay which
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what is pure increaced intracranial pressure symptoms?
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headache
nausea/vomiting papilledema 6th never palsy-double vision of far stuff obscurattion of vision |
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what is the false localising sign 6th nerve palsy
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doesnt tell us where the issue it just somthing that is effected when the pressure goes up
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what is the problem seen in the retina during ICP increase?
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swollen disc
looks out of focus when viewed |
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what is increased ICP in its pure form referred to as?
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pseudo tumor cerebri
idiopathic intracranial hypternsion benign intracranial hypertension |
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what is the ICP in ventriculomegaly syndrome?
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can occur with or without increased ICP
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what are early signs of ventricluomegally syndrome?
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gait apraxia, incontinence
can occur due to stretching of nerve fibers to those areas and it occurs before the manifestation of all the symptoms of increased ICP. |
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what is primary CNS trauma?
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impact which causes:
diffuse axonal, SAH, subdural and epidural hemor, skull fracture, cranial nerve injury, arterial dissecion, dura/arachnoid injury. |
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what is secondary CNS trauma?
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injury occurs with decreased CBF and O2
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what is the major role in treatment of CNS injury?
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prevent secondary injury
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what are the priorties after CNS injury?
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ABC(airway, bleeding, cerebrum)
BBBBBB(breathing, bleeding, brain, bowel, bladder, bone) always continue spinal precautions till radiaoligic confirmation itsok |
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what is mini neuro scores?
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eye opening 4/4
verbal response 5/5 best motor resopnse 6/6 15 best score worst 3 ICP monitor at 8 or less |
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what scaning should be used in CNS injury?
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CT its faster and less worry of magnetic problems interefereing with treatment
CT is better for finding blood |
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what does divergent gaze mean?
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unconsiousness takes effort to bring eyes to focus
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multiple punctuated deficits with brain origin would be caused by what?
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axonal injury
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what is shown on "drift"
eye's closed pronator drift and sagging of the arm |
test of motor and proprioceptive issues
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how do u treat brain hematoma?
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ventilate-hyperventilate to control CO2
treate with diuretics |
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dilated pupil indiactes what?
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same side as lesion
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lens hematoma?
concave and convex hematoma? |
1.subdural
2. epidural |
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hematoma that spreads evenly amoung the cystern?
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subarachinoid
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what occurs in a chronic subdural hematoma?
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vascular membrane around hematoma leaks blood slowly growing the hematoma
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