Neuro Flashcards
Increased pressure on the oculi motor nerve decreases parasympathetic stimulation. Sympathetic stimulation will predominate. Pupils will look like?
Dilated
Bilateral Pupil dilation is an early or late sign of increases ICP?
Late
Reflex, motor, and vision changes are contralateral, or ipsilateral, to the side of the injury?
Contralateral
Eyes deviate Toward, or away from the side of the injury?
Toward
What is the one neurological problem that causes pupil dilation BEFORE sustained change in level of consciousness?
Uncal herniation
Protein is increased or decreased in the CSF of bacterial meningitis?
Increased
What are the 2 major complications of subarachnoid hemorrhage?
Rebleed
Vasospasm
What is the treatment for vasospasm ?
Aggressive fluid administration
Seizures are an early or late sign of brain tumors?
Early
What is always the 1st sign of a neuro Problem?
Change in level of consciousness
Which is detected first?
Pronator drift? Or strength changes?
Pronator drift
Vital sign changes are an Early, or Late sign of neurological injury?
Late (indicates that the brain stem is involved. )
Uncal herniation occurs when…
The temporal lobe is displaced against the brainstem and 3rd cranial nerve (oculomotor).
What is the most common cause of uncal herniation?
Epidural hematoma in the temporal area
Central herniation is caused by….
Swelling on both sides, downward displacement of both hemispheres.
Cerebral edema secondary to encephalopathy or stroke can cause….
Central herniation
What should always be ruled out before treating an acute ischemic stroke?
Hypoglycemia (May mimic stroke symptoms)
Patient has stroked and the BP is 219/119. Should you give antihypertensive??
No,do not treat unless SBP > 220 or DBP > 120. Suddenly decrease in BP will decrease perfusion to an area of the brain that has already lost perfusion, and may increase size of the ischemic area.
Patient is here for MI but suddenly strokes. Should you give tpa?
No (MI in the past three months is contraindication for tpa.)
Pt has stroke symptoms, CT of the head is negative
Should you give tpa?
Yes (CT head is an inclusion criteria for tpa administration)
What is the goal BP for the first 24h after tpa administration?
SBP < 180
DBP < 105