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7 Cards in this Set

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Types of Cerebral Oedema

Vasogenic (↑ cap permeability): trauma, tumour, ischaemia, infection


Cytotoxic: e.g. from hypoxia


Interstitial: e.g. obstructive hydrocephalus, ↓Na+

Causes

Haemorrhage


Tumours


Infection: meningitis, encephalitis, abscess


Hydrocephalus


Status


Cerebral oedema

Signs and Symptoms

Headache


n/v Seizures


Drowsiness → coma


Cushing’s reflex: ↑BP, ↓HR, irregular breathing 6th CN palsy (may be false localising)


Cheyne-Stokes respiration


Pupils: constriction → dilatation


Papilloedema, loss of venous pulsation @ disc

Herniation SyndromesTonsillar (Coning)

 ↑ pressure in posterior fossa → displacement of cerebellar tonsils through foramen magnum


 → compression of brainstem and cardioresp centres in medulla


 CN6 palsy, upgoing plantars → irregular breathing → apnoea

Transtentorial / Uncal

Lateral supratentorial mass → compression of ipsilateral inferomedial temporal lobe (uncus) against free margin oftentorium cerebelli.


Ipsilateral CN3 palsy: mydriasis (dilation) then down-and-out


Ipsilateral corticospinal tract: contralateral hemiparesis


May → compression of contralateral corticospinal tracts → ipsilateral hemiparesis (Kernohan’s Notch: False Localising)

Subfalcine

Frontal mass


Displacement of cingulate gyrus (medial frontal lobe) under falx cerebri


Compression of ACA → stroke


Contralateral motor/sensory loss in legs>arms Abulia (pathological laziness)

Acute Management