Neuro Flashcards
Systemic problems affecting the brain?
- Shock/hypotension
- Hypoxia
- Intoxication
- Metabolic disturbances (Hypoglycaemia)
- Hypercapnia
Primary brain problems affecting levels of consciousness ?
- Structural
- Trauma
- CVA
- ICH
- Infection
- Seizures
Meningism?
This can occur in SAH and meningitis. Resistance against neck flexion
Components of ICP?
- Blood
- Brain tissue
- CSF
What is the normal range of ICP?
10 - 20 mmHg
Components of the cushing’s reflex?
- Hypertension
- Bradycardia
- Abnormal respiratory pattern
What is the CPP?
MAP - ICP
Cerebral autoregulation is maintained in a range of CPP?
60 - 160 mmHg
Systemic problems affecting the brain?
- Shock/Hypotension
- Hypoxia
- Intoxication
- Metabolic disturbances (Low BM/High CO2)
Primary brain pathologies?
- Structural - trauma, stroke or ICH
- Infection - Seizures or status
Determinants of raised ICP?
- Brain tissue
- Blood
- CSF
What is normal ICP?
10-20mmHg
What are the potential causes of raised ICP?
- ICH
- Abscess
- Oedema
- Hydrocephalus
- Reduced outflow of blood - Venous clot
- Cerebral venous sinus thromboses
what is tentorial herniation?
- Cerebrum - Uncus of temporal lobe
- Forced through tentorium downwards
- mid-brain compression
What is tonsillar herniation?
- Coning
- Movement of cerebellar tonsils downwards through the foramen magnum
- Compression of medulla & brainstem dysfunction
What is the Cushing’s reflex in relation to brainstem dysfunction?
- Hypertension
- Bradycardia
- Abnormal respiratory pattern
What is CPP?
MAP - ICP
Factors affecting cerebral blood flow?
- High arterial tension of CO2 (Dialtion)
- Low arterial tension of CO2 (Constriction)
Management of high ICP?
- Intubate
- Head elevation to 30 degrees
- Sedation & NMB
- MAP > 80 + Vasopressor use
- Hyperventilaton
- Hypertonic saline or Mannitol
What are the causes of secondary brain injury?
- Inflammatory response
- Hypotension
- Hypoxia
- Anaemia
- Elevated ICP
- Seizures
- Pyrexia
What is subarachnoid haemorrhage ?
Bleeding into the space between the arachnoid membrane and pia mater
What are the common causes of SAH?
- Cerebral aneurysm
- Blood in the subarachnoid space causes inflammation and vasospasm
What are the consequences of SAH?
- Delayed cerebral ishcaemia
- Low GCS within 4-10 days
- Obstructive hydrocephalus
- MI
- Pulmonary oedema
What is the common causative agent for encephalitis?
Viral infection
