NCMB 418 (CU 11 PART 1 and 2) Flashcards
pressure ≥20 mmHg
Increased Intracranial pressure
A dynamic scare that reflects the pressure of cerebrospinal (CSF) within the skull
Increased Intracranial pressure
The ability of the brain to tolerate increases in intracranial volume without adversely increasing
ICP (Monro-Kellie Hypothesis)
Intracranial compliance
The ability of the brain to tolerate and compensate for an increase in intracranial volume through
distention or displacement
Intracranial elastance
a pressure gradient across the brain and is the difference between the arterial blood
entering and the return of venous blood exiting the neurovascular system.
CPP
formula for CPP
MAP – ICP
formula for MAP
systolic BP + 2x diastolic BP / 3
Purposes of ICP and CPP Monitoring:
- To diagnose increased ICP
- Enable interventions
- Provide a tool for predicting the level of injury and patient outcome.
Head injury is injury to the scalp, skull, or brain
TRAUMATIC BRAIN INJURY
- initial damage to the brain that results from the traumatic event.
- may include contusions,
lacerations, torn blood
vessels from impact, acceleration/
deceleration, or foreign
object penetration
Primary injury
evolves over the ensuing hours and days after the initial injury and is due primarily to brain swelling or ongoing bleeding
Secondary injury
most important consideration in any head injury
Brain Injury
If the frontal lobe is affected =
If temporal lobe is affected =
= bizarre irrational behavior
= temporary amnesia or disorientation
- Temporary loss of neurologic function with no apparent structural damage
- Generally involves a period of unconsciousness lasting from a few seconds to a few minutes.
Concussion
A more severe injury; brain is bruised with possible surface hemorrhage
Contusion
Vital signs: BP & temperature – subnormal (somewhat similar to that of shock
Contusion
Hematomas (collections of blood) that develop within the cranial vault
Intracranial Hemorrhage
blood collecting in the epidural (extradural) space between the skull and the dura
Epidural Hematoma
collection of blood between the dura and the brain (space is normally
occupied by a thin cushion of fluid)
Subdural Hematoma
Increased ICP MGT:
- Maintain adequate oxygenation, elevate the head of the bed, maintain normal blood volume
- Devices to monitor ICP or drain CSF
a sudden, abnormal, excessive discharge of electrical activity within the brain that disrupts
the brain’s usual system for nerve conduction
Seizure
definitive test to diagnose seizure activity
Electroencephalography (EEG)
scan of choice for a diagnostic evaluation of certain types of CNS disorders
SPECT scan
a seizure that lasts
longer than 5 minutes, or more than 1 seizure within a 5-minute period, without returning to normal
level of consciousness between episodes
Status Epilepticus
