CNS Flashcards
Infection predominantly involving the subarachnoid space (Meninges)
Meningitis
Infection diffusely involving the brain tissue
Encephalitis
Focal infection of brain tissue with no capsule formation
Cerebritis
Focal infection of brain tissue with capsule formation
Abscess
General Routes of CNS Infections: (enumerate the 5 routes)
- Hematogenous
- Direct of Local Extension
- Implantation
- Along nervous system pathways
- Bony defects
General Routes of CNS Infections: Hematogenous
__________: From primary infection in the lungs or heart valves
Arterial
General Routes of CNS Infections: Hematogenous
__________: From infected scalp veins, orbital infections via the cavernous sinus
Venous
From the mastoid, middle ear, sinuses, or infected tooth
Direct of Local Extension
As a result of mechanical trauma (gunshot wound, surgical procedures e.g. craniotomy, or lumbar puncture)
- Implantation
Usually occurs in viral infections like Rabies, Herpes Zoster, and
Poliomyelitis
Along nervous system pathways
Congenital or acquired (fractures)
Bony defects
_______ plus signs of brain parenchymal involvement which can result to altered sensorium, behavioral changes, psychosis.
Meningismus
In addition to the acute febrile illness with evidence of meningeal involvement, the patient commonly has an? (Name the 3)
- altered LOC
- depressed LOC
- focal or diffuse neurologic signs and symptoms
Common Etiologies of Viral Encephalitis
- Herpes viruses (Herpes Simplex Virus 1)
- Varicella zoster virus
- Epstein Barr virus
- Arthropod-borne viruses
- La Cross Virus
- West Nile Virus
- St. Louis encephalitis virus
Less Common Etiologies of Viral Encephalitis
- Rabies
- Eastern equine encephalitis
virus - Western equine encephalitis
virus - Powassan virus
- Cytomegalovirus
- Enterovirus
- Colorado tick fever
- Mumps
Laboratory Diagnosis of the CSF Profile in Viral ENCEPHALITIS
*CSF lymphocytic pleocytosis, normal glucose, normal or mildly elevated protein
*20% may be hemorrhagic
Laboratory Diagnosis Of Viral Encephalitis:
- CSF TEST
- MRI
- EEG
- PCR STUDIES
- VIRAL CULTURE
- SEROLOGIC STUDIES
Clinical Presentation Of V. E
- Meningismus MINUS profound alteration in consciousness, seizures and
focal deficits - Headache (frontal or retroorbital)
- Photophobia
- Pain in moving the eyes
Constitutional signs Of V.E
- Malaise
- Myalgia
- Anorexia
- Nausea and vomiting
- Abdominal pain and/or diarrhea
Treatment (V. ENCEPHALITIS)
*May be empiric or symptomatic
*May be treated as an outpatient basis
*Hospitalize if immunocompromised or with signs of encephalitis
*Acyclovir 10 mg/kg/day for 14 to 21 days
*Seizure control with anticonvulsants
Nursing Management For V.E
*Assess for neurologic function
*Initiate seizure precaution
Maintain a quiet environment
*Administer fluids as ordered
*Measure input and output
Prevention and Control Measures For V.E
*Secretion precautions
*Wearing of long-sleeved shirts and long pants *Use of mosquito repellant and netting *Mosquito and tick control
is a zoonotic, vector-borne virus, spread
primarily by Culex mosquitoes.
Japanese encephalitis virus (JEV)
_____ is one of the most
important causes of human viral encephalitis in Asia .
Japanese encephalitis virus (JEV)
Various species of birds are the
natural reservoir
are considered the main maintenance or amplifying host.
pigs
Virus that belongs to Flavi Virus common in Southeast Asia.
Japanese Encephalitis Virus
Causative agent for JEV
Japanese Encephalitis Virus
Mode of transmission For JEV
bite of infect mosquito “Culex Species” and may become infected and also biting pigs, horse and birds
Signs and Symptoms For JEV ( increased ICP)
✔ Flexor Posturing: flexion of the elbows with external rotation (specific damage to
✔ cortex) Also known as Decorticate Posturing (one E for both: flExor = decorticatE).
✔ Extensor Posturing: rigid extension of the neck, arms and legs (extensive cortex injury)
✔ also known as Decerebrate Posturing (count the letter “E”. multiple E for both: 4 in
✔ DEcErEbratE 2 E in ExtEnsor).
Signs and Symptoms For JEV
- fever
- ⬆️ ICP DAMAGES INDICATES:
1. Cerebral cortex damage
2. Headache not relieved by pain meds
3. stroke respiration
4. Apnea
5. Hemianopia
6. Hemiparesis or paralysis
7. Doll’s Eye Reflex