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15 Cards in this Set
- Front
- Back
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What are the causes of aneurysms?
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Due to weaknesses in cerebral artery endothelium
Most commonly at the bifurcation of an artery Causes include: atherosclerosis, congenital abnormalities, trauma, inflammation, or infection The weakened arterial wall "balloons" out threatening to rupture Can be found in cerebral arteries an thoracic and abdominal aorta |
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What are the symptoms/signs/manifestations of aneurysms?
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Symptoms tend to manifest within hours to days prior to rupture
Due to interrupted blood flow or increased intracranial pressure in a particular part of the brain BAD HEADACHE, STIFF NECK, VASOSPASM, BLOOD IN CSF, SUBARACHNOID HEMORRHAGE Blood in the CSF indicates small hemorrhages of the aneurysm Rupture of cerebral aneurysm resulting in subarachnoid hemorrhage is usually fatal |
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Describe primary brain injuries.
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Usually due to trauma, and is defined as direct injury, or destruction of a cell
Neural injury affects conduction of action potentials A primary vascular response results in increased cellular permeability to solutes leading to some of the secondary injuries |
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What are the secondary effects of brain injuries?
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HEMORRHAGE of injured blood vessels, increasing fluid of the interstitial fluid space compressing the surrounding tissue, and vasogenic edema increases intracranial pressure resulting in a hyperirritability
ISCHEMIA (lack of O2) results in additional cell destruction ALTERED MEMBRANE PERMEABILITY: Ca influx slows the enzymes of aerobic respiration causing decrease of ATP. Na accumulates inside the cell with H2O causing cellular edema GLUTAMATE RELEASE from injured cells makes the membrane more permeable to Na and K |
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What is tertiary brain injury?
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It occurs in other places in the body as a result of primary and secondary traumatic brain injury
APNEA, HYPOTENSION, CHANGES IN PULMONARY RESISTANCE, AND ALTERATIONS OF ECG WAVES |
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What is a hematoma?
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Focal brain injuries usually result in hemorrhage leading to hematoma.
Hematoma is pooled blood, which has moved out of an injured blood vessel into the interstitial fluid space |
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Extradural hematoma
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Occurs due to injury of the middle or anterior meningeal artery or vein or the dural sinus, occurs rapidly
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Subdural hematoma
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Occurs due to injury of the bridging veins in the subdural space. Hemorrhage forming this hematoma occurs slowly; compression or herniation of brain tissue is up into the dural space frequently results from this type of hematoma
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Intracerebral hematoma
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Occurs deep in the white matter of the brain. Damaged small blood vessels slowly bleed, greatly increasing intracranial pressure
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Subarachnoid hematoma
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Results from impaired cerebrospinal fluid flow in the subarachnoid space; inflammation or cerebral compression frequently cause this particular hematoma; there is a great increase in intracranial pressure resulting in tissue destruction and necrosis.
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What manifestations of subarachnoid hematomas are different than other types of hematoma?
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Kerning's sign
Hemiparesis-weakened muscles or partial paralyisi on one side of the body Srudzinski's sign-flexion of a lower limb on one side including flexion of the limb on the other side. |
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Whe are the main manifestations common to extradural, bubdural, intracerebral hematomas?
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Loss of consciousness followed by lucid period
Loss of reflexes to break fall transient cessation of respiration Brief period of bradycardia and low BP Brief period of increased ECG activity |
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What are the causes of Cerebro-vascular Accident (stroke)?
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Interrupted blood flow to a certain area of the brain
Atheroslerosis/hypertension cause clots or hemorrhages Extent of damage determines if the manifestations are temporary or permanent Since stroke is blood vessel disease many of the same risk factors are similar to atherosclerosis, hypertension, and heart disease |
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What are the risk factors for CVA?
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Hypertension
Smoking Diabetes mellitus or insulin resistance Polycythemia (excessive RBC) Thrombocytenia Impaired cardiac function Hyperhomocysteinemia Atrial fibrillation Estrogen deficiency in post-menopausal women |
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What causes thrombotic strokes and what are the 3 stages of thrombotic strokes?
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The are due to arterial occlusions
3 stages: 1. Transient Ischemic Attack-caused by small thromi intermittently blocking circulation in small blood vessels, neurological deficits within 24h 2. Stroke in Evolution (progressive stroke)-interittent progression of neurological deficits over hours to days, due to thrombis or slow hemorrhage 3. Completed Stroke-lodged thrombus causing max damage |
