data processing deficits and alterations in cerebral hemodynamics - Sheet1 Flashcards
What is delirium?
Temporary, acute mental confusion that can be life-threatening.
What are the three classifications of delirium?
Hyperactive, hypoactive, or mixed.
How long does delirium typically last?
1-7 days, but it can persist longer and become chronic.
How is delirium different from dementia?
Delirium has a sudden onset, while dementia progresses gradually.
What are the risk factors for delirium?
Older males, history of stroke, depression, dementia, cognitive impairment, or substance use.
What mechanisms contribute to delirium?
Impairment of cerebral oxidative mechanisms, hypoperfusion, neurotransmitter abnormalities (e.g., cholinergic deficiency, excess dopamine), proinflammatory state, cortisol excess.
What are some possible causes of delirium inside of the hospital?
Alcohol and drug abuse, medication side effects, polypharmacy (these are also outside), sleep deprivation, unfamiliar environments, sensory overload/deprivation, emotional stress, pain, restraint use.
What are the manifestations of delirium?
Hypoactivity or lethargy, hyperactivity, agitation, hallucinations, misinterpretation, impulsiveness, inability to concentrate, disorganized thinking, irritability, insomnia, loss of appetite, restlessness, “picking” behavior, confusion.
What is “sundowning”?
Increased confusion at night.
How is delirium diagnosed?
Through history and physical exam, lab tests (e.g., UA, thyroid tests, liver function tests, alcohol/drug screen), head CT/MRI, and the Confusion Assessment Method (CAM) in ICUs.
What is cerebral edema?
A net accumulation of water in brain tissue due to trauma, infection, hemorrhage, tumor, ischemia, infarct, or hypoxia.
What are the harmful effects of cerebral edema?
Distortion of blood vessels, displacement of brain tissues, and herniation.
What mechanisms lead to cerebral edema?
Increased permeability of capillary endothelium or damage to brain cells.
How is cerebral edema diagnosed?
Through history and physical exam, CT, or MRI.
What is hydrocephalus?
A condition characterized by excess CSF in the cranial vault, subarachnoid space, or both, leading to increased ICP.
What mechanisms lead to hydrocephalus?
Increased CSF production, obstruction in the ventricular system, or impaired absorption of CSF from the subarachnoid space.
What are the manifestations of hydrocephalus?
Rapid onset or slow progression, “Megamind” appearance in children, bulging fontanelles, decline in consciousness, memory, and cognition, history of falling, poor concentration, and indifference.
How is hydrocephalus diagnosed?
Head CT or MRI.
What are herniation syndromes?
Shifting of brain tissue from high-pressure to low-pressure areas, which can affect brain function and lead to collapse of ventricles.
What are common manifestations of herniation syndromes?
Poor concentration, drowsiness leading to loss of consciousness, pupillary changes, Cheyne-Stokes respirations, hemodynamic instability, hypercapnia.
