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10 Cards in this Set
- Front
- Back
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Swelling of the brain leads to....
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1) narrowed sulci and flattened gyri
2) blood flow to brain becomes impaired Symptoms include: headache, nausea and vomiting (if the chemoreceptors in the medulla are compressed and activated), papilledema (water from swollen brain tracts down the optic nerve to the eye, which you can see on an eye exam), or even focal signs and seizures |
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If the edema/swelling of the brain is not alleviated, this can lead to ______ syndromes. Name three varieties of this type of syndrome.
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1) Herniation syndromes
2) a. subfalcine herniation b. transtentorial herniation = uncal herniation c. cerebellar tonsillar herniation |
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1) What is a subfalcine herniation?
2) The subfalcine herniation leads to the compression of _____ which causes an infarction in the _________. |
1) occurs when swelling pushes brain parenchyma UNDERNEATH FALX CEREBRI at the midline of the cerebrum
2) anterior cerebral artery; medial frontal cortex |
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1) What is a transtentorial herniation or an uncal herniation?
2) What nerve does a transtentorial herniation compress and what results? 3) What vessel does a transtentorial herniation compress and what results? |
1) portion of the brain parenchyma is pushed BENEATH THE TENTORIUM CEREBELLI that lies atop the cerebellum
2) compression of oculomotor nerve; pupillary dilation 3) compression of posterior cerebral artery; occipital lobe infarction |
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What is Kernohan's notch?
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Kernohan's notch - when the a lesion pushes the brainstem over and the cerebral peduncle on the opposite side is compressed, which results in a deficit on the ipsilateral side to the lesion (because opposite spinal-thalamic tracts are compressed.)
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What occurs when the brainstem is compressed?
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Compression of brainstem → necrosis of contralateral cerebral peduncle → hemiplegia ipsilateral to the mass lesion and rupture of small blood vessels in the midbrain and pons → DURET HEMORRHAGE → brain-dead
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1) What is cerebellar tonsillar herniation?
2) T/F Cerebellar tonsillar herniation is not an immediate medical emergency you can wait a few days before you can go to the doctor. Hell you should go to ihop before you go.... 3) How would you treat this? Should you resect the tonsils? |
1) Cerebellar Tonsillar Herniation - severely elevated intracranial pressure leads to pushing of brain downward into foramen magnum → impact the medulla → compress respiratory centers → DEATH
2) FALSE FALSE FALSE Tonsillar herniations are NEUROSURGICAL EMERGENCY 3) REMOVE THE PRESSURE by drilling a Burr hole into the skull (anywhere is fine, JUST GET THE PRESSURE OUT ); do NOT resect the tonsils DO NOT RESECT THE TONSILS |
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What are the several layers beneath the skull and what are their associated potential spaces where blood can accumulate?
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Dura Mater
-epidural space is above the dura mater periosteum; below the skull - subdural space btw dura and arachnoid Arachnoid Mater -subarachnoid space is between arachnoid and pia (where CSF flows) Pia Mater - single cell layer on surface of brain itself |
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The Blood-Brain Barrier: created by tight-junctions between the endothelial cells in the blood vessels and epithelial cells in the choroid plexus
1) What does disruption of the blood brain barrier lead to? 2) What are the two kinds of edema? |
1) Disruption of this barrier leads to leaking of fluid into interstitial fluid space → can lead to EDEMA
2) a) vasogenic edema b) cytotoxic edema |
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Explain what vasogenic edema is.
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Vasogenic Edema - result of injury to blood-brain barrier such that its structural integrity is damaged
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