Neuro Patho Flashcards
1
Q
What is meningitis?
A
- Inflammation/infection of meninges around the brain or spinal cord
- Caused by bacteria, viruses, fungi, parasites, or toxins
- Source: normal inhabitants that get into wrong place, bloodstream infections, trauma, fracture
- Young, old, immunocompromised are most at risk
2
Q
Bacterial meningitis
A
- AKA septic (viral is called aseptic)
- Strep pneumonia: most common in adults and 2nd most common in peds
- Neisseria meningitides: most common in peds
- E coli and GBS: most common in newborns
3
Q
Pathophysiology of Meningitis
A
- Invading organism leads to inflammatory response (neutrophils, exudate block flow of CSF) which leads to cerebral changes (increased ICP and disrupt blood supply, risk of ischemia)
- Continued exacerbation of inflammatory response
4
Q
Clinical manifestations of meningitis
A
- Infectious: fever, tachycardia, chills, petechial rash
- Neurologic: all related to increased ICP (decreased LOC, cranial nerves, seizures, irritability, delirium)
- Irritation of meninges: throbbing headache, photophobia, nuchal rigidity (stiff neck), Brudzinski’s sign (bend neck up and child will flex knees), Kernig’s sign (flex hip 90 degrees and try to extend knee but painful)
5
Q
Evaluation of meningitis
A
- History and physical
- Lumbar puncture: culture and gram stain, increased pressure, CSF (find high WBCs, high neutrophils, high protein
- Bacterial = low glucose
- Viral = normal glucose
6
Q
Treatment of meningitis
A
- Bacterial = IV antibiotics
- Viral = antiviral and steroids
- Manage complications
- Supportive: rest, comfort measures, dark rooms, decreased stimulation
7
Q
Prevention of meningitis
A
- Vaccination
- Screening
- Active treatment of primary sources
8
Q
Increased Intracranial Pressure
A
- Cranium = fixed volume container that holds brain matter, CSF, and blood
- Less fixed in babies until fontanels close
- ICP = pressure exerted by contents of the cranium
- Normal = 0-15 mmHg
9
Q
Etiology of ICP
A
- Most common causes in adults: stroke, brain trauma, tumors
- Peds common causes: tumor, structural malformations, infections
10
Q
3 causes of Increased ICP
A
- Cerebral edema (accumulation of fluid): vasogenic or cytotoxic edema and often occur together
- Space-occupying processes: tumor, hematoma, abscess
- Hydrocephalus: excessive accumulation of CSF
11
Q
Clinical manifestations of ICP
A
- headaches
- Changes in LOC
- Changes in eyes: pupils, vision
- Vomiting
- Changes in vital signs: increased systolic BP, decreased pulse, altered respiratory pattern (Cushing’s Triad)
- Seizures
- Decreased motor function
- Posturing
- Infants: bulging fontanels, increased head circumference, high pitched cry, poor feeding, sun-seeing eyes
12
Q
Evaluation of ICP
A
- History and physical
- Imaging
- Lumbar puncture: tells us about infectious process
13
Q
Treatment of ICP
A
- Treat underlying cause
- Monitor and alleviate pressure
- Cerebral oxygenation
- Pharm
14
Q
Seizures
A
- Transient neurologic event with excessive/abnormal electrical discharges
- Alteration in membrane potential that makes certain neurons abnormally hyperactive and hypersensitive to changes
- Interaction of complex genetic mutations with environmental effects that cause issues
15
Q
Variation within seizures
A
- Causes are different across the lifespan
- 1/2 of all causes are idiopathic (unknown cause)
- Classification: symptoms and ECG features
- Clinical manifestations depend on area of brain involved and where they spread (must do specific assessment)
