CH45 Neuro Trauma Flashcards
Define a Concussion
Concussion - also referred to as a mild TBI, involves an alteration in mental status that results from trauma, and may or may not involve loss of consciousness. This typically lasts longer than 24 hours and may include symptoms such as headache, nausea, vomiting, photophobia, amnesia and blurry vision.
What is a Halo Sign?
A blood stain surrounded by a yellowish stain (CSF fluid), which may be seen on bed linens or on the head dressing.
Define a Cerebral Contusion
Cerebral Contusion - A more severe injury than a concussion, involving bruising of the brain, with possible surface hemorrhage.
Why are older adults more prone to Subdural Hematomas?
Older adults are more prone to Subdural Hematomas because of cerebral atrophy. This causes fragile bridging veins, which run between the dura and the brain to tear as the atrophied brain pulls away from the dura.
Describe Cushing’s Response and Cushing’s Triad.
1) Cushing’s Response - A compensatory response that attempts to restore blood flow by increasing arterial pressure to overcome the increased intracranial pressure; this includes ⬆ systolic pressure, widening pulse pressure, and bradycardia.
2) Cushing’s Triad - The 3 classic signs (bradycardia, hypertension, and bradypnea) that represent a loss of compensatory mechanisms (a result of Brainstem dysfunction).
What’s the difference between an Acute and a Subacute Subdural Hematoma?
1) Acute Subdural Hematoma - Associated with major head injury involving a contusion or laceration. Clinical symptoms develop over 24-48 hours.
2) Subacute Subdural Hematomas - A result of a less severe contusion or head trauma. Clinical manifestations usually appear between 48 hours and 2 weeks after the injury.
Explain the Monroe-Kellie Hypothesis
The Monroe-Kellie Hypothesis states that because of the l,omitted space for expansion within the skull, an increase in any of the 3 components (brain tissue, blood or CSF), causes a change in volume of the others.
Where is ICP usually measured and what is a normal range of value for ICP?
ICP is usually measured in the lateral ventricles, with normal pressure being 5-15 mmHg.
How does increased ICP affect BP, pulse and respiration?
1) BP ⬆
2) Pulse is slow and bounding
3) Irregular respirations
Which 6 methods can be used to decrease ICP?
1) Osmotic diuretics
2) Fluid restriction
3) CSF draining
4) Controlling fever because temperature ⬆ metabolic activity
5) Reducing cellular metabolic demands
6) Maintaining systemic BP and oxygenation
Define Cheyne-Stokes Breathing
Cheyne-Stokes Breathing is is irregular breathing with a random sequence of deep and shallow breaths (a late indication of ⬆ ICP).
(T/F) Mannitol becomes ineffective when the serum Osmolarity exceeds 320 mOsm.
True
How is Mean Arterial Pressure Calculated?
MAP = {Systolic + 2(Diastolic)} / 3
What is the normal range of value for CPP?
CPP = 70 - 100 mmHg;
Ischemic CPP = 40 - 70 mmHg
Infarction/brain death = CPP < 40
No flow = CPP of < 30
How do you calculate CPP?
CPP = MAP - ICP
