Neurological Flashcards
Stroke
Damage to brain by interuptions of blood supply
Hemorrhagic Stroke
blood leaks out of damaged blood vessels into interstitial space
-brain tissue deprived of O2
-blood in skull rises intracranial pressure
Ischemic Stroke
-bv delivering O2 to the brain is blocked
-position determines the extent of the damage
What does a pupillary check involve
-PEARL
-pupils equal and reactive to light
-Bi-lateral dilation and movement
GCS - Glasgow coma scale
Eyes response /4
Verbal response /5
Motor response /6
Neurological Assessment
- pupillary check
- GSC
- level/loss of consciousness
-observed behaviors - evaluation of cranial nerves
-motor strength and function
-vitals
Cushings Triad
bradycardia, irregular respirations, and a widened pulse pressure.
- neurological emergency
-indicates a severe increase in ICP
Diffuse Axonal Injury
tearing of axons that happens when the brain is injured as it shifts and rotates inside the skull.
Coup
coup injury is associated with a moving object impacting a stationary head (brain)
Countercoup
-brain rebounds and strikes the opposite side of skull
Contusion
bruising or bleeding in the brain
brain cells will likely die
Concussion
-TBI
-brief disruption in LOC and amnesia due to head injury
Focal vs Diffuse Head injury
focal: confined to one area of the brain
- haematoma
- contusion
diffuse: happens in more than one area of the brain
-concussion
-diffuse axonal injury
Subarachnoid Hemorrhage (SAH)
- bleeding in the space that surrounds the brain
-often caused by an aneurysm
Subdural hematoma
bleeding in the subdural space, between the dura mater and arachnoid layer
Aneurysm
- abnormal artery wall distension
-ruptured leads to brain bleeds
Intracranial Hematoma
bleeding within the brain
Coiling
-Catheter inserted into aneurysm
-coils are packed into a dome and promote clotting
-closes the aneurysm and remove rupture risk
Clipping
surgical clip to close off aneurysm in the brain
Burrholes
used to relieve pressure off the brain when fluids build up
-small hole and tube
Craniotomy
section of the skull temporarily removed for surgeons to access the haematoma
Haematoma
collection of blood outside of blood vessels.
-usually caused by blood leaking out of a damaged vessel
Intracranial Pressure (ICP)
pressure exerted by fluids inside the skull on the brain tissue
Monro Kellie hypothesis
an increase in volume of one intracranial component (CSF, blood, brain tissue) must be compensated by a decrease in in one or more of the other component
- volume must remain fixed
Encephalitis
inflammation of active tissues of the brain
Increased ICP causes
-tumor, stroke, hypertension, infection, head injury, ruptured aneurysm, meningitis, cerebral oedema
Cerebral Oedema
Swelling on the brain
Cerebral edema causes
1) mass lessons: abscess, tumor, heamorrhage
2) Head Injury: contusion, post-traumatic brain swelling
3) Brain Surgery
4) Cerebral Infection
ICP progression
- initial cranial insult
- tissue oedema
- BV compression
-decrease in blood flow and O2
-death of brain cells
-increase in ICP
-compression of brain stem
-CO2 accumulation
-vasodilation
-DEATHHHH 💀
ICP treatment
- IV mannitol
-hyperventilation
-draining excess fluid
ICP complications
- inadequate cerebral perfussion
- ischamia and oedema further increased
- further compression of brain steam
Haemorrhage
release of blood from a broken blood vessel, either inside or outside the body
