Inflammatory Brain Disorders

Question 1

Bacterial Meningitis

Answer 1

• medical emergency: mortality 100% if untreated
• organisms enter thru respiratory tract/bloodstream
• often follows viral respiratory disease (pneumonia)
• increase CSF production and ICF

Question 2

Bacterial Meningitis Manifestations

Answer 2

• fever, headache
• NV, decrease in LOC
• nuchal rigidity
• photopia
• Positive Kernigs and Brud sign
• noncommunicating hydrocephalus if CSF flow is obstructed

Question 3

What causes unconsciousness in bacterial meningitis

Answer 3

Increased ICP

Question 4

What does acute cerebral edema in bacterial meningitis cause

Answer 4

Seizures
CN 3 Palsy
Bradycardia
Hypertensive Coma
Death

Question 5

Waterhouse-Friderichsen Syndrome

Answer 5

Adrenal gland failure due to bacterial infection

Question 6

Bacterial Meningitis Dx

Answer 6

Blood culture
Lumbar puncture and analysis of CSF (gram stained smear)
X-rays of skull
CT and MRI

Question 7

Bacterial Meningitis care

Answer 7

Antibiotics after collection of specimens: able to cross blood-brain barrier
Examine eye fundus before lumbar puncture to identify increased ICP

Question 8

Viral meningitis

Answer 8

Caused by Estero virus, arbovirus, HIV, HSV

• headache, fever, photophobia, stiff neck
• Dx of CSF: lymphocytosis, no organisms from gram stained or acid fast
• PCR to detect viral specific DNA/RNA
• symptomatic management with full recovery

Question 9

Encephalitis

Answer 9

Inflammation of brain

• sometimes fatal
• cause by viruses, West Nile virus
• ticks/mosquitoes can transmit epidemic encephalitis
• CMV encephalitis is common with AIDS
• RF: advanced age
• mild flu like symptoms

Question 10

Encephalitis Dx

Answer 10

CT or MRI
PET
PCR
Blood test for West Nile

Question 11

Encephalitis Nursing Management

Answer 11

• mosquito control for prevention
• Acyclovir for HSV infection: start before onset of coma
• anti seizure drugs for seizures

Question 12

Brain abscess

Answer 12

Accumulation of pus within the brain tissue

• ear, tooth, mastoid, or sinus infection
• skull fracture or brain trauma
• causative: strep and staph
• headache, fever, NV, signs of increased ICP

Question 13

Abscess Care

Answer 13

• Dx: CT and MRI
• antimicrobial therapy
• symptomatic treatment
• abscess may need to be drained or removed
• near 100% mortality of untreated

Question 14

Rabies

Answer 14

• threat greater for developing countries
• RNA virus that cause acute, progressive viral encephalitis
• transmitted via saliva from animal bite or scratch/mucous membranes
• any warm blooded animal can carry(most common: rabid dogs)

Question 15

Rabies Manifestations

Answer 15

2-14 days after exposure: flu like symptoms, pain, parenthesias
2-7 days later: acute neuro syndrome (agitation, hypersalivation)
Coma develops within 7-10 days of neuro syndrome
-experience flaccid paralysis, apnea, hydrophobia, seizures
-death as result of respiratory/cardio collapse within few days of coma