Neuro emergencies Flashcards
1
Q
Altered mental status- Sx
A
- Change in arousal, consciousness
- Delirium, dementia and coma
2
Q
Altered mental status- Tx
A
- Determine underlying cause
- Glucose
- Stabilize vitals
3
Q
Coma- Sx
A
- Unarousable to stimuli, including pain
- Doll eyes
4
Q
Coma- Tx
A
- Tx underlying cause
5
Q
Stroke/ TIA- Sx
A
- Jumbled speech- aphasia and apraxia
- Unilateral motor deficits
- AMS
6
Q
Stroke/ TIA- Tx
A
- Airway
- Asses for trauma
- Tx cerebral edema
- Thrombolysis if indicated
7
Q
Status epilepticus- Sx
A
- Seizure lasting 5-15 min with out intervening periods of consciousness
8
Q
Status epilepticus-Tx
A
- Protect airway
- Benzos then phenytoin
9
Q
Spinal cord injury- Sx
A
- Head injury or trauma as mech of action
- Neuro deficits and complaints
- AMS, seiure
10
Q
Spinal cord injury- Tx
A
- Immediate immobilization
- ABCs
11
Q
Headache- Sx
A
- Sudden severe onset most concerning
- Focal neuro defecits
- Hx or trauma or nuchal rigidity, photophobia
12
Q
Headache- Tx
A
- CT to determine if emergency
- Neuro consult
13
Q
Syncope- Sx
A
- Transient loc
- May be due to CV issues, seizure
14
Q
Syncope- Tx
A
- Determine and tx underlying cause
- ECG, vitals
15
Q
Meningitis/ encephalitis- Sx
A
- Nuchal rigidity, photophobia, CSF findings
- Seizures and CN deficits
16
Q
Meningitis/ encephalitis- Tx
A
- Abx and steroids
17
Q
Basilar skull fracture- Sx
A
- Base of skull- temporal occipital sphenoid or ethmoid
- Sig force fracture to base
- Sig risk for inter-cranial fx
- Otorrhea and rhinorrhea due to torn dura
- Battle signs and raccoon eyes
18
Q
Basilarskull fracture- Tx
A
- Caution for epidural hematoma
- Order CT
- Consult neuro
19
Q
Epidural hematoma- Sx
A
- Head trauma and LOC
- Lucid interval
- Rapid neuro deterioration
- Blood between skull and dura
- Increased IC pressure
- Lenticular shape
20
Q
Epidural hematoma- Tx
A
- Evacuate fluid for recovery
21
Q
Subdural hematoma- Sx
A
- Sudden acceleration
- Hematoma between dura and arachnoid
- Slower collection longer time course
- Falling elders chronic x 2 weeks
- Crescent shaped on CT
22
Q
Subdural hematoma- Tx
A
- Reverse anticoagulation
- Surg to evacuate
23
Q
Subarachnoid hemorrhage- Sx
A
- Sudden onset of HA worst of life
- Thunder-clap
- Meningeal signs photophobia
- Blood in CSF
24
Q
Diffuse axonal injury- Sx
A
- Disruption of axonal fibers
- post-traumatic coma
- GCS 3-8
- Amnesia > 7 days
- CT- poor grey-white matter discrimination
punctuate hemorrhages cerebral edema
25
Concussion- Sx
Grade 1: Transient confusion, no LOC. sx 15 min
- Grade 3: LOC
Other sx: amnesia, vomiting, confusion, behavior change
- GCS 13-15
26
Concussion- Tx
Grade 1: Remove from contest
- Grade 2: Remove, return after 1 wk asymptom
- Grade 3: 1-2 asymp wks
27
Moderate head trauma- Sx
- Initial GCS 9-12
| - Post traumatic amnesia 24 hrs - 7 days
28
Mild to moderate head trauma- Tx
- Close f/u with PCP
29
Diffuse axonal injury- Tx
- Reduce cerebral edema
- Mannitol
- Volume resuscitation
30
Skull fracture- Sx
- Open- underlying laceraciton
- Closed- swelling and hematoma
- Depressed- visible on CT, palpation
31
Skull fx- Tx
- Open- abx, consult neuro
- Closed- Close observation
- Depressed- hospitalize and consult
32
Whiplash= Sx
- Appear 12-24 hrs after injury
- Tenderness, limited ROM
- Hoarse, dysphagia
- No neuro defecit
33
Whiplash- Tx
- Xray and MRI
- Immobilization
- Musc relaxants, heat, NSAIDs
34
Encephalopathy- Sx
- AMS
- Ophthalmoplegia, ataxia and confusion
- Tremors
- wide, unsteady gait
- Decerebrate posturing
35
Encephalopathy- Tx
- Thiamine for wernikes
- Lactulose for hepatic
- glucose fluids and benzos for metabolic
