71 Neurological Emergencies

Question 1

Pediatic Head Trauma

• What are the 7 most common reasons for this?

Answer 1

Question 2

CT Scans

• Why do you always use caution with pediatric patients?

Answer 2

Question 3

Pecarn Rule

• What is this used for?
• How sensitive is this?

Answer 3

Question 4

Concussion

• What is the definiton of this?
  
  • Where does it rank on the GCS?
• What symptoms occur after?
• What is second impact syndrome, and what does it result in?

Answer 4

Question 5

Post Concussive Syndrome

• What symptoms do ppatients have?
• Is this more common in women or men?
• How long do symptoms last?
• Does this correlate with severity of injury?
• What will a CT scan show?
• What may develop from repated head trauma?

Answer 5

Question 6

Biomarker for Head Injury

• What protein is used?
  
  • Where is found?
  • What does it do?
• When is it releaed?
• How sensitive is this as a Dx tool?
• How specific is this as a Dx tool?

Answer 6

Question 7

Skull Fractures

• What kind of fractures are not signficant?
• Why would a leptomeningeal cyst develop?
• How big does a depressed fracture have to be in order to require surgery?

Answer 7

Question 8

Open and Depressed Skull Fracture

• What will you see on a CT?
• What will need to be done SURGICALY to prevent an infection?
  
  • What about after the surgery?

Answer 8

Question 9

Answer 9

Basilar Skull Fracture

Question 10

Basilar Skull Fracture

• What bone is most commonly fractures?
  
  • What other bones can be affected?
• What clinical signs show up? (3)
• What is this associated with?

Answer 10

Can lead to a CSF leak

Question 11

CSF Leak

• What is this a complication of?
  
  • How often does it happen?
• What is a hallmark of CSF leak?
• What risk does a CSF leak have?

Answer 11

Question 12

What does this CT show?

Answer 12

Question 13

What does this CT show?

Answer 13

Question 14

What is shown on this CT?

Answer 14

Subdural Hematoma

Question 15

Subdural Hematoma

• How does this relate to aging?
• How long do bleeds take?
• What is notable about small hematomas?
• What is notable about large hematomas?

Answer 15

Question 16

Tx of Bleeding Disorders

• What do you need to do if patient has a brain bleed?
  
  • What drugs fall under this category?
  • How do you reverese them?

Answer 16

Question 17

Cushing’s Triad/Reflex

• What makes up this?

Answer 17

Question 18

Epidural Hematoma

• What strucutres does this occur between?
• What arteries are usualyl involved?
  
  • What artery is the most commmon?
    
    • What kind of fracture will tear this artery?
• How does arterial bleeding present?
• Why may some patients seek treatment when this occurs?
• What does surgery require?

Answer 18

Question 19

Epidural Hematoma

• How do you prevent herniation?

Answer 19

Question 20

Monro-Kellie Doctrine

• What does this state?
• Why does ICP rise?
• How can one provide pressure buffering during surgery?

Answer 20

Question 21

Cerebral Perfusion Pressure

• What components make up this?

Answer 21

Question 22

ICP

• How do you measure it?
  
  • What else can this device do?
• What is the goal for ICP?
  
  • for CPP?

Answer 22

Question 23

Hyperventialation

• What molecule can make the cerebral blood vessells constrict/dialte?

Answer 23

Question 24

Hyperventialation

• What does an increase in PaCO2 do to cerebral blood vessels?
• What does a decrease in PaCO2 do to cerebral blood vessels?
• What chance in PaCO2 reduces ICP?
  
  • How does this affect CCP?
• When is hyperventilation used treatment?
  
  • What is the degree of PaCO2 change when this is done?

Answer 24

Question 25

Hyperventilation * What device are patients with severe brain injury usually hooked up to? * What drugs can redice ICP? * How do control a patients minute ventilation via ventilator?

Answer 25

Question 26

ICP Control: Other * Why is the head of the bead placed at 30 degrees? * What do you avoid puttin gon the patient?

Answer 26

Question 27

Osmotic Therapy * What two drugs/substances are used? * What does this do to the content of the blood? * What happens to the brain? * What may happen initially?

Answer 27

Question 28

Hypothermia and TBI * What evidence suppots this? * What is the current standart of care? * When can hyperthermia be used?

Answer 28

Question 29

Surgical Tx * What are the indications for a craniotomy or burr hole? * What are these not routinely done for? * Decompressive Craniectomy * What is this and why is it done?

Answer 29

Question 30

Antiseizure Meds * When are these recommended? Why? * What do these notably not do? * What 3 drugs are recommened? * What drug is used for acute cases?

Answer 30

Question 31

TBI w/ GCS less than 8 * Prognosis * What is the risk of death? * What percent of patients end up in a persistent vegetative state? * What percent of patients end up recovering in 6 to 12 months? (Not full recovery)

Answer 31

Question 32

Preventing Secondary Brain Injury * What three things need to be done?

Answer 32

Question 33

How do you tell the difference between epidural and subdural hematomas?

Answer 33