Acute Brain Injury

Question 1

How are acute brain injuries characterized?

Answer 1

rapidly progressing neurologic deficits and life-threatening complications

Question 2

what is the difference between ischemia and hypoxia?

Answer 2

ischemia is the reduction of blood flow which is insufficient to meet metabolic demand and hypoxia is the reduction of oxygen at the cellular level

Question 3

What are the common mechanisms of acute brain injuries?

Answer 3

ischemia, immune-mediated damage, free radical damage, and intracellular CA2+ overload

Question 4

What is the most critical factor to treat during an acute brain injury?

Answer 4

reducing brain ischemia

Question 5

How is ICP defined?

Answer 5

increase pressure exerted by the contents of the cranium and its normal ranges (0-15mmHg)

Question 6

What are the most common causes of ICP?

Answer 6

stroke, trauma, tumors and primary and secondary disorders

Question 7

an increase in brain tissue volume commonly occurs from conditions that cause what?

Answer 7

cerebral edema

Question 8

vasogenic edema

Answer 8

results from extravasation of electrolytes, proteins, and fluid into the intracellular space. consequence of stroke, ischemia, and severe hypertension

Question 9

cytotoxic edema

Answer 9

ischemia tissues swell because of cellular energy failure

Question 10

Si/Sx of ICP

Answer 10

headache, vomiting, drowsiness. patient may complain of blurry vision, papilledema.

Question 11

A dreaded complication elevation of ICP is ____ and ____?

Answer 11

compression and herniation

Question 12

Herniation

Answer 12

protrusion of brain tissues through an opening in the supporting dura of the brain

Question 13

where is the most common location of brain herniation?

Answer 13

falx cerebri

Question 14

what are the assessments for those with acute brain injury?

Answer 14

level of consciousness (Glasgow coma scale), and cranial nerve reflexes, and hemodynamics

Question 15

What are the 3 cranial nerves that are assessed for acute brain injury?

Answer 15

pupil, oculovestibular, and corneal reflexes

Question 16

What are the type of injuries of brain tissues as a consequence of trauma?

Answer 16

traumatic brain injuries

Question 17

How are TBIs characterized?

Answer 17

severity, location, and mechanism

Question 18

What are the 3 types of primary injury?

Answer 18

focal (localized site of impact to the skull), polar (brain shift within in the skull) and diffuse (movement of brain causes widespread neuronal damage from the cranial cavity and causes comas)

Question 19

What are the types of hematomas?

Answer 19

subdural, subarachnoid, epidural

Question 20

What are the 2 types of subarachnoid hemorrhages? Which has the highest mortality rate?

Answer 20

cerebral aneurysms and AVMs

Question 21

How is an aneurysm developed?

Answer 21

multifactorial interaction of hypertension, atherosclerosis, and congenital predisposition

Question 22

If Frank comes into the clinic complaining that he is experiencing the worst headache he has ever had, what might this be a result of? What also might Frank be experiencing?

Answer 22

warning leak of a ruptured aneurysm. he might be experiencing photophobia, nausea and or vomiting and stiff neck

Question 23

AVM (arteriovenous malformation)

Answer 23

vascular lesions that causes arterial blood to be directly shunted into the venous system causing high venous pressure

Question 24

Meningitis

Answer 24

the most common sequela to microbial invasion of the CNS, most commonly causes by bacteria but can also be viral or fungal

Question 25

Meningitis pathogenesis

Answer 25

pyogenic infection that invades the leptomeninges and the subarachnoid space. this infection travels readily around the brain and spinal cord

Question 26

SI/SX of meningitis

Answer 26

headache, fever, stiff neck, delirium and confusion

Question 27

Encephalitis

Answer 27

an inflammation of the brain caused by a variety of agents including viruses, bacteria, fungi and parasites

Question 28

SI/SX of encephalitis

Answer 28

fever, headache, seizure, confusion, stupor, and coma. hallucinations, personality changes, and psychotic behavior may also occur

Question 29

Brain abscess

Answer 29

a localized collection of pus within the brain parenchyma, most are bacterial (strep, staph, and anaerobes)

Question 30

circle of willis

Answer 30

the anterior and posterior communicating arteries connect cerebral arteries on opposing sides to supply the other side or back and front of the brain `

Question 31

Why is neuronal tissues highly sensitive to oxygen deprivation?

Answer 31

has great ATP requirements and limited capacity for anaerobic metabolism during ischemia