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17 Cards in this Set
- Front
- Back
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Papilledema suggests...
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Intracranial mass or pseudotumor Cerebri
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Acute Headache suggests
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Superimposed Event (e.g., bleed)
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Subarachnoid Hemorrhage
Now what? |
1. Transfer to ICU
2. Keep SBP < 165 3. Cerebral angiogram to assess for aneurysm |
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Normal CT w/ sudden headache
What now? |
1. Lumbar puncture for RBC's
2. Consult neurology or neurosurgery 3. Possible Cerebral angiogram |
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Red Flags in Headache
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1. "Worst headache in my life"
2. "This is different from my usual headaches" 3. Meningismus 4. Syncope or focal neurologic deficits 5. Worsening of headache w/ positional changes 6. Papilledema 7. High Fever |
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Awake
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able to maintain wakefulness w/o stimulation
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Sleepy
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Arousable, but tends to fall asleep after a short period w/o stimulation
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Stupor
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Arousable but unable to maintain wakefulness w/o continuous stimulation
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Coma
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Unarousable w/ any stimulation
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Diminished LOC
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lesion in the reticular activating system
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Metabolic coma location
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affects bilateral cerebral hemispheres
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Metabolic coma labs
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low glucose
low oxygen thiamine deficiency electrolyte imbalance medication overdose |
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Structural coma location
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lesion in brainstem or bilateral thalami or bilateral hemispheres
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Structural coma etiology
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brainstem stroke
mass in one hemisphere compressing on the other hemisphere |
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Metabolic coma differential
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hypotension (dehydration)
hypoglycemia low O2 (MI, PE) Infection - UTI, pneu, CNS Hyponatremia Hypocalcemia Uremia (kidney or liver) Narcotics, anti-cholinergics Tox screen Low thiamine (Wernicke's) |
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Structural coma workup
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CT (head) - hemorrhage?
EEG - status epilepticus? MRI - stroke |
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Partial seizure
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abnormal firing of a small part of the cortex
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