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6 Cards in this Set
- Front
- Back
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Subfalcine herniation
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midline shift
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Uncal herniation
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corticospinal tract compression - contralateral hemiparesis
compression of cerebral peduncle compression of CNIII - ipsilateral blown pupil PCA compression |
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Tonsillar herniation
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compression of brainstem: respiratory depression, death
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Cushing's Triad
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Reflex to brainstem compression:
1. Bradycardia 2. Respiratory Irregularity 3. HTN |
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Initial management of ABI
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AB(intubation)C
D: GCS + rapid neuro exam Imaging: CT for stable pts with GCS<15 or abnormal NE |
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ICP management
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0. Optimize physiology
1. Venous drainage 2. CSF drainage (bleeding, infections) 3. Sedation/paralysis: (+) decreased metabolism, perfusion reqs and venous congestion; (-) reduced exam, potential for hypotension and ischemia 4. Hyperosmolar agents: (+) diuretic effect, rheologic effect; (-) dehydration, nephrotox, osmoles to brain making rebound icp 5. Hyperventilation: (+) decreases CO2 which reduces caliber; (-) risk of ischemia 6. Barbs: reduce metab but risks hypotension 7. Surgical decompression 8. Hypothermia |
