Neurological conditions and management Flashcards
Why does a stroke happen?
happens when the blood supply to the brain is cut off
What does BEFAST stand for?
balance, eyes, face, arms, speech, time.
What are the two stroke types?
ischemic, Haemorrhagic strokes
What causes an ischemic stroke?
caused by thrombus or embolus obstructing the cerebral circulation - blood vessels becoming blocked.
What are the risk factors of an ischemic stroke?
Genetics, smoking, obesity, sickle cell disease, blood pressure, high LCL cholestrol, atrial fibrillation and drugs such as cocaine.
What part of the brain suffers in an ischemic stroke?
Only the portion of the brain distal to the block will suffer.
What are the signs and symptoms of an ischemic stroke?
Tingling in the arms, slurred speech, motor issues, changes in vision, total loss of vision in one eye, dysphasia and facial droop.
How do you assess a possible ischemic stroke?
Primary survey. ABCDE approach and BEFAST.
What should you look at to make sure you have done all the checks for a stroke patient?
stroke care bundle
What is the percentage for ischemic strokes
Approx 85%
What is the second type of stroke
Haemorrhagic
How many main types are there of a Haemorrhagic stroke?
Two
What is the first type of Haemorrhagic stroke?
Bleeding within the brain cavity itself (intercerebral or intercranial haemorrhage)
How does an intercranial haemorrhage work?
Artery within the brain ruptures causing bleeding, leading to a rise in the intercranial pressure.
What is the second main type of Haemorrhagic stroke?
Bleeding on the surface, surrounding the cranium, subarachnoid haemorrhage (SAH) - MOST COMMON. most often caused by a burst aneurusym.
What risks can cause this type of stroke?
Hypertension
What is the treatment for a haemorrhagic stroke?
Medication to reduce hypertension, surgery.
What is a transient ischeamic stroke?
“mini stroke”, episode of cerebral ischaemia that do not cause any lasting damage. Presents with signs and symptoms of a stroke but resolve within 24 hours.
What is a seizure/ convulsions
An abnormal and excessive depolarisation of a set of neurons in the brain. It sometimes resulting in a period of involuntary muscular or motor contractionas.
What is an epileptic seizure?
A neurological condition resulting in a possible convulson. Includes persistent and continous seizure lasting 30 mins max termed.
What is a Eclamptic seizure?
Occurs prenatually and is associated with pregnancy hypertension.
What is a ferbrile induced seizure?
Generally very young children, caused by a fever.
What is epilepsy?
A neurological disorder marked by a sudden recurrent episode of sensory disturbance, loss of consciousness or convulsions.
What are some epilepsy triggers?
Not taking, feeling tired, not sleeping well, stress, alcohol or recreational drugs, missing meals, fever.
What is a psychogenic non epileptic seizures (PNES)?
Involuntary psycholigical response to distress, commonly associated with emotional trauma. involves attacks that resemble epilepsy-related seizures in symptoms and signs, but abnormal electrical activity in your brain doesn’t cause them.
What is ineffective with PNES?
Drug therapy
What is meningitus?
Inflammation of the membranes that cover the brain and spinal cord called the meninges.
Can meningitus be both bacterial and virus?
Yes if it is bacterial it is a communicable disease and is spread via droplets and must be reported to PHE.
What are signs and symptoms of meningitus?
Classic features include neck stiffness, photophobia, haemorrhagic rash. Non specific signs include nausea, vomiting and a sore throat. Other signs include a fever, rigors and tachycardia.
What is the management of menigitus?
ABCDE approach, Oxygen maintain sats between 94% to 98%. IV fluids, benzylpenicllin. Time critical transfer and a handover.
What is a cluster headache?
excruciating unilateral pain with parasympathetic autonomic activation in the same eye.
What does a cluster headache cause?
Redness or tearing of the eye, nasal congestion.
How long do the attacks last for a cluster headache?
30-90mins and they can occur several times a day. It lasts for 1 to 2 months before stopping and happening again a year later.
What is the management for cluster headaches?
Analgesics are unhelpful, subcutaneous sumatriptan helps for acute treatment. High flow oxygen also used.
What is a tension type headache similar too?
A migraine
What happens in a tension type headache?
Pain is usually mild to moderate severity with tight band sensations, pressure behind the eyes and bursting sensations.
What helps a tension type headache?
Simple analgesics are often effective (paracetamol, aspirin, NSAIDS(ibroprofen)). Physical treatment such as ice packs may help.
What is a migraine?
Episode of headache that is associated with the sensativity like light, sound or movement and sometimes causes nausea or vomiting.
How does a migraine occur?
Happens by a wave of depolarisation followed by depressed acitivty slowly spreading anterioly across the cerebral cortex from the occipital region. Activation of the trigeminal pain neurons is the basis of the headache.
