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Complex > Neuro 6 > Flashcards

Neuro 6 Flashcards

1
Q

what is contre-coup

A

injury affects the side opposite to the blow because of rebound (horizontal section)

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2
Q

concussion vs contusion

A

concussion (swelling/bruise… goes away) and contusion (torn and bleeds)

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3
Q

a TBI that changes the way your brain functions

A

concussion

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4
Q

types of skull fractures

A

Hairline, depression, compound (multiple bones), hematomas

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5
Q

describe epidural bleed

A
  • bleeding between the dura mater and skull

- may see the bleeding out of nose, go unconscious quickly

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6
Q

describe subdural bleed

A
  • bleeding between the arachnoid mater and dura mater
  • may take up to 4 days to show signs of problem (may be too late)
  • *this type is worse as it is less obvious
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7
Q

describe raccoon eyes

A
  • hit to the back of the head (conte-coup injury)

- as brain pushed forward, have bleeding around eyes (occipital, really bad)

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8
Q

s/s of concussion

A

Vomiting, amnesia, dizziness, lethargy

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9
Q

over time, recurrent concussions cause

A

causes damage to internal structures of thalamus

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10
Q

Blow to the head, brain hits the skull, not cause contusion, temporary dysfunction
Recovers 24-48 hrs

A

concussion

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11
Q

management of mild concussion

A

Quiet and contained for 24-48 hrs (no rapid movement of eyes)

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12
Q
  • Most common in 20-40 years old
  • BLEED d/t fracture
  • arterial bleeding, blood between skull and dura, linear skull fx over middle meningeal artery or venous sinus
A

contusion

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13
Q

s/s of contusion

A

Scalp wound, drowsiness, loss of consciousness, labored respirations, hemiparesis, posturing, unequal pupils

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14
Q

describe epidural hematoma

A

**lose consciuoness quickly (surgical intervention to stop bleed or remove blood)

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15
Q

s/s of epidural hematoma

A

Unconscious, then lucid for minutes to hours, severe headache, progressive loss of consciousness, compression of brain stem, respirations become shallow and irregular, pupil dilation, seizures

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16
Q

describe subdural hematoma

A

take longer to develop but same s/s as epidural

slower onset

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17
Q

a pool of blood forming underneath the skull

A

hematoma

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18
Q

describe intracerebral hematoma

A

d/t leaking aneurism

19
Q

s/s of intracerebral hematoma

A

Unresponsive immediately, lucid and then progress to coma, motor deficits and posturing

20
Q

what are battle signs

A

bruising over mastoid bone/face/sinus bruising

21
Q

what should you look for if skull fracture suspected

A

Look for CSF leakage (ears or nose is REALLY BAD, fracture within skull, cannot put CSF back)

22
Q

s/s of skull fracture

A

Motor and sensory deficits depending on where trauma occurs, periorbital ecchymosis (raccoon eyes), CSF leakage from ears, ecchymosis over the mastoid bone (battle’s sign)facial paralysis with basilar skull fractures, posterior basilar fractures may disrupt respirations.

23
Q

treatment of TBI

A

Same as treatment of ICP:

  • Assess cognition, level of arousal
  • Assess eyes, motor, brainstem, respiratory function
  • Control ICP, maintain CPP and oxygenation
  • Prevent seizures, normal temp, normal fluid and electrolytes
  • evacuate bleed if there is one
  • Prevent sympathetic storming
24
Q

describe storming

A
  • Diaphoresis, agitation, restlessness or flexion, hyperventilation, tachycardia and fever
  • May occur with suctioning or turning
  • Treated with Beta blockers
25
Q

what are the worst brain tumors and what is the general treatment

A

Gliomas are the worst

Remove tumors and do radiation

26
Q

brain tumor management

A
  • After surgery: decadron, an anti-inflammatory steroid (given with radiation)
  • Radiation will make their brain swell/hot and make them vomit (give Zofran)
27
Q

brain tumor treatment

A

1) Radiation Therapy: First line treatment is stereotactic (gamma knife or linear accelerator)
2) Surgery: Craniotomy- surgery for brain tumor
3) Medications: Corticosteroids to reduce cerebral edema and antiepileptic medications
4) Chemotherapy: Orally, IV or in the resected area of the brain

28
Q

describe cerebral aneurysm

A

-is a bulging, weakened area in the wall of an artery in the brain, resulting in an abnormal widening, ballooning, or bleb.
-Not good, If not caught in time will kill you once major arteries rupture
Clipping or coiling with aneurysm

29
Q

describe AVM

A
  • An abnormal connection between arteries and veins, usually in the brain or spine, that can rupture
  • May show up when pregnant (treat with clipping)
30
Q

what is an aneurysm

A

A ballooning and weakened area in an artery.

31
Q

Grading of Aneurysms

A

Hunt-Hess Scale

32
Q

sections of Hunt-Hess

A

1) mild headache, GCS 15, no motor deficits, normal mental status
2) severe headache, GCS 13-14, no motor deficits, normal mental status
3) somnolent, confused, GCS 13-14, MOTOR DEFICITS,
4) stupor, GCS 7-12, w/ or w/out motor deficits (moderate to severe)
5) coma, reflex posturing or flaccid, GSC <6, w/ or w/out motor deficits

33
Q

surgical treatment of aneurysms

A

clipping and coiling

34
Q

treatment of aneurysms

A
  • Monitor for bleeding, vital signs, neuro status
  • After surgery- monitor for vasospasms, 3-12 days after, watch for headaches, change in LOC
  • Treatment is Nimodipine
  • ICU for 2 days after surgery
35
Q

why is nimodipine gien

A

Calcium channel blocker to prevent spasms and vasopressors to keep the systolic BP 20 mmHg greater than normal

36
Q

describe encephalitis

A
  • Bacteria or virus that invades the brain (must have way to get in)
  • through head trauma, sinus cavity, or ear
  • equine virus through mosquitoes
37
Q

s/s of encephalitis

A

Inflammation of the brain
Symptoms:
Headache, fever, confusion, stiff neck and vomiting

38
Q

complications of encephalitis

A

Seizures, hallucinations, trouble speaking, memory problems and problems hearing

39
Q

causes of encephalitis

A

Viruses (herpes simplex, rabies) bacteria, parasites and fungus

40
Q

treatment of encephalitis

A
  • MRI, lumbar puncture for elevated ICP and testing of CSF
  • Polymerase chain reaction (PCR) testing of CSG to detect viral DNA
  • *Remove fluid, Ventilated, EVD drain to decrease swelling
41
Q

supportive care of encephalitis

A 
Antivirals or antibiotics
Steroids
Sedatives for restlessness
Tylenol for fever
Therapy
42
Q

encephalitis prognosis poor if…

A

Cerebral edema
Thrombocytopenia
Status epilepticus

43
Q

main drug to decrease inflammation if increased ICP

A

steroids

44
Q

basic treatment for neuro problems

A

Give oxygen, stable airway, maintain ICP and notify providers!

Complex (38 decks)

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