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49 Cards in this Set
- Front
- Back
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What are the conditions causing injury to the brain? |
- trauma - tumors - stroke - metabolic derangements - degenerative disorders. |
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What are the effects of hypoxia to the brain? |
- unconsciousness occurs within seconds. - energy sources depleted in minutes. - Sodium potassium and other pumps stop. - Influx of sodium into and glutamate, an excretory AA, out of neurons. - Interstitial oedema - Influx of Ca - Increased blood viscosity. - Cognitive defects. |
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Explain the injury from excitatory AA during hypoxia to the brain. |
During prolonged ischaemia, extracellular glutamine accumulates. Toxicity occurs and neurons are damaged or die. Microneurons are vulnerable. Creating subtle reductions in cognitive/memory. |
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What is increased intracranial volume and pressure? |
- also called intracranial hypertension - common pathway for brain injury. - Obstruction of cerebral blood flow, destruction of brain cells, displacement of brain tissue, and damage to delicate brain structures. - Cranial cavity 10% blood, 80% blood tissue, 10% CSF |
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What are the manifestations of brain injury? |
- Alterations in sensory and motor function - Changes in the level of consciousness (the full awareness of self, location and time). |
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What is TIA? |
Transient ischaemic attack |
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What are the features of TIA? |
- brief, reversible - cerebral hypoxia - spasm of atherosclerotic vessels. - numbness, mild weakness - Transient visual disturbances possible |
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What are the pharmacological treatment of TIA's? |
- Aspirin - Anti platelet drugs - Surgical treatment to deuce the atherosclerotic plaque. |
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What is the complementary treatment for comanagement of patients prone to TIA? |
Gingko: - neuroprotective properties under hypoxic conditions. - inhibits vasospasm and thrombus formation - improve cerebral blood flow to under perfused areas. - Dietary modifications to help decrease atherosclerotic plaques. |
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What is CVA? |
Cerebral vascular accident Stroke Brain attack |
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What are the features of CVA? |
- obstruction in brain blood flow - high risk: hypertension, diabetes, hypercholesterolaemia, heart disease. - Swelling and oedema follows 24 to 73 hrs after neuronal cell death. |
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What are the two general classifications of CVA? |
Ischaemic and haemorrhagic |
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What is the ischaemic condition of CVA? |
- interruption in blood flow. - 70-80% of all strokes. |
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What is the hemorrhagic condition of CVA? |
-bleeding into brain tissue. |
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What is a thrombotic stroke? |
- occlusion of blood flow - severe atherosclerosis |
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What is an embolic stroke? |
- formed outside the brain gets lodged. |
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What is a hemorrhagic stroke? |
- blood vessels in the brain broken - most frequently fatal stroke |
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What are the signs and symptoms of cerebral aneurysms? |
- are asymptomatic for small condition. - Large condition may cause chronic headache, neurologic deficits, or both. - other manifestations: meningeal irritation, cranial nerve deficits, stroke syndrome, cerebral oedema and increased ICP and pituitary dysfunction. - Hypertension and cardiac dysrhythmias result from massive release of catecholamines triggered by the subarachnoid haemorrhage. |
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What is the feature of aneurysmal subarachnoid haemorrhage? |
- bleeding into the subarachnoid space - cause by: * congenital defect * acute increase in ICP * Cigarette smoking * Hypertension * Excessive alcohol intake. |
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Which type of stroke is the result of a ruptured blood vessels? a. Ischemic b. TIA c. Arteriovenous malformation d. Hemorrhagic |
Hemorrhagic: these strokes are caused by rupturing major blood vessels. |
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What are the risk factors and the deficits of stroke? |
- Age, gender, race - Family history - Hypertension - Smoking - Diabetes mellitus - Asymptomatic carotid stenosis. - Sickle cells disease. - Hyperlipidemia - Atrial fibrillation - Stroke related deficits: Motor/ Dysarthria / Aphasia / Cognitive and other deficits. |
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What is a coup injury? |
- direct contusion of brain at site of external force |
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What is a contra coup injury? |
- rebound injury of brain on opposite side of skull. |
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What is the sequelae of coup-contracoup? |
- concussion - Post concussion syndrome - Traumatic brain injury - Intracranial / intercerebral haematomas |
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What is TBI? |
- Traumatic brain injury |
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What is the primary TBI? |
- damage caused by impact: contusion, laceration, haemorrhage. |
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What is the secondary TBI? |
- damage to subsequent swelling, infection, or cerebral hypoxia. |
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What are the types of hematomas? |
- Epidural: tear in artery - Subdural: tear in bridging veins. - Intracerebral |
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What are the symptoms of TBI and post-concussion syndrome? What are the people most affected by it? |
- leading cause of death and disability younger people then 24 years old. - Symptoms: * headache * Irritability * Insomnia * Poor concentration and memory |
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What are the infections of the CNS? |
- Meningitis - Encephalitis - Myelitis - Encephalomyelitis |
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Give the area of infection for each disease: 1. Meningitis 2. Encephalitis 3. Myelitis 4. Encephalomyelitis |
1. Meninges 2. Brain parenchyma 3. Spinal cord. 4. Brain and spinal cord |
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What type of invading organism are found in CNS infection? |
Bacteria, viral and other |
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What are the features of meningitis? |
- infection of pia matter, arachnoid and the CSF. - caused by bacteria - immune and inflammatory reactions. - Children younger than 5 |
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What are the clinical manifestations of meningitis? |
- headache, decreased consciousness and vomitting. - Fever - Photophobia from pailloedema. - Seizures |
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What are the tests for meningitis? and treatment? |
- Brudzinski sign - CSF examined. - Antibiotic |
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Encephalitis |
- infection of the brain or spinal cord. - usually caused by a virus. - cranial oedema can degenerate the nerve cell bodies. - neurologic disturbances common in encephalitis. |
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What are the causes of encephalitis? |
- polio virus (destroy cells of the anterior horn) - arbovirus (mosquito) - rabies virus (rabid animals) - Herpes - EBV - Cytomegalovirus infection - Herpes simplex. - Herpes zoster - Measles - Mumps - HIV - Polio - Rabies |
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What are the types of brain tumours? |
- Primary intracranial: neuroepithelial and non euro-epithelia - Metastatic tumours: bone, liver, lungs, bowel, prostate. |
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What are the symptoms of brain tumours? |
- Increased ICP - Focal disturbances in brain function - Oedema - Disturbances in blood flow - Tumour infiltration - Brain compression |
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What are the treatment and evaluation of Brain tumours? |
- surgery - irradiation - chemotherapy - MRI - CT scans - Electroencephalogram - Physical and neurology examination |
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What is a seizure? |
- abnormal behaviour caused by a sudden electrical discharge from neurons in the cerebral cortex. - discrete clinical event with associated signs and symptoms which vary according to the site of neuronal discharge in the brain. |
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What is convulsion? |
- specific seizure type of a motor seizure involving the entire body. |
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What is epilepsy? |
- recurrent episodes of convulsive seizures |
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What are primary seizures? |
- symptom of an underlying CNS dysfunction. - cerebral neurons exist in a hyper excitable or easily depolarised state (epileptogenic focus. - the current can spread to neighbouring cells, causing them to discharge. |
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What are the secondary seizures? |
- occur during serious illnesses or injuries. - severe metabolic abnormalities occurs - hypoxemia - hypoglycaemia - acidemia - alkalemia -dehydratation |
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What is a diffuse seizure? |
- generalised seizure - consciousness is always lost. |
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What are the features of seizures? |
- discreet focus - limited to one side of the brain. - consciousness is usually not lost - status epilepticus: one seizure is followed by more |
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What is a tonic clonic seizures? |
- sudden onset rigid, intense contractions of arm and leg muscles. - Rhythmic contractions and relaxation of the muscles. |
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What are the clinical manifestations of seizures? |
- Strange sensations and perceptions including hallucinations - Unusual or repetitive muscle movements. - Confusional state or loss consciousness - A prodoma may precede seizure - If status epilepticus, death occurs. |
