Neuro Acute 2 Flashcards
metabolic disorder etiology of sezirues
Acidosis
Electrolyte imbalance
Hypoglycemia
Hypoxia
Alcohol or barbiturate withdrawal
Drug intoxication
prognosis of epilepsy/seizure is linked to?
underlying etiology of seizures
patients with primary epilepsy
can grow out of their seizure or may be well controlled on their medications
definition of status epilepticus
seizure activity persisting for more than 5 minutes
drug noncompliance, cns infection, metabolic disturbances, sleep deprivation, stroke, trauma, or encephalitis; with drawl of
what is the treatment for status epilepticus
check the sugar
initial drug of choice of status epilepticus
benzodizapem
pam,lam, dam
not iv access during a seizure
rectal or IM
IV is not that only route to go
if the benzos dont work during a seizure
fosphenytoin, valproic aic and or levetiracetam
compliacation of status epileptuicus
Hypertension
Lactic acidosis
Hyperthermia
Respiratory compromise
Pulmonary aspiration
Rhabdomylosis
Irreversible neurological damage
monroe kellie hypothesis
brain tissue, blood,
brain tumor globlastoma
most serious
4 % only survive
Commonly nonspecific, and complaints of increased ICP. As the tumor grows, focal deficits develop
Course is rapidly progressive with poor prognosis. Total surgical removal is usually not possible and response to radiation therapy is poor.
brain tumor meningioma
can be removed
Originates from the dura mater or arachnoid. Compresses rather than invades adjacent neural structures. Symptoms vary with tumor site. Tumor usually benign and readily detected by CT
Treatment is surgical. Tumor may recur if removal is incomplete. If removal incomplete, pts may undergo radiation to decrease the risk of recurrence.
brain tumor astrocytoma
slower growing
A glioma similar to glioblastoma multiforme, but its course is more protracted, often extending for several years.
Prognosis variable. By the time of diagnosis total excision is usually impossible; tumor often is not radiosensitive. In cerebellar astrocytoma, total surgical removal is often possible.
clinical manifestation of a brain tumor
H/A, N/V
Weakness, hemiparesis
Sensory disturbances
Altered mental status
Impaired gait
Aphasia, agraphia
Papilledema, diplopia, diminished visual acuity
Generalized or focal seizure activity (30%)
enlarged nerve, double vision, diminshed visual acuity
hydrocephalus
disturbance of csf formation, flow or absorption leading to an increase volume overload by the fluid in the central nervous system
how do you dx a brain tumor that is highly sensitive?
MRI
hallmark manifestation for menigitis
Fever
Nuchal rigidity
Altered sensorium
Severe H/A
Photophobia
Chills,myalgias
Kernig’s sign
Brudzinski’s sign
N/V
Purpura or petechiae ( bacterial going into the blood stream)
bacterial meningitis*
kernigs sign
k-knee cannot extent due to pain when hip flexed go 90 degrees
knee extension is painful
brudzinskis sign
b-bend the neck hips and knees flex
neck flexion leads to knee flex
dx of bacterial menigitis
lumbar puncture
inc icp? on ct very important********
if they have inc icp on ct for a meningitis patient? the epidural cath can?
herniate
lumbar puncture in bacterial meningitis
Appearance of CSF
Opening pressure- >180mmH2O (due to inflammation)
Cells (inc wbc)
Total protein (increased)
Glucose (will be decreased)
Culture
normally its clear, if its cloudy then bacterial
lumbar puncture in viral meningitis
Appearance of CSF
Opening pressure
Cells (inc wbc)
Total protein (normal)
Glucose (normal)
Culture (normal)
CT head is indicated for
pts with focal neurological signs or diminished loc.
Pt’s with s/s and csf findings typical of bacterial meningitis, but no organisms are found
