Neurological emergency Flashcards
How do you resus in paeds?
Airway
Breathing
Circulation
Glucose
Name causes of neurological emergency
Acute
- stroke
- bleed
- seizure
- toxins
- infections
- metabolic
Subacute
- brain tumour
- hydrocephalus
- IEM
Discuss your approach to examining a child during a neurological emergency
- Vitals
- ICP
- Meningeal irritation
- Skull trauma
- Seizure activity (tongue, incontinence)
- Neurological
- GCS
- breathing
- eyes
- posture
- focal signs - Rest of body
What lesion causes Cheyne-Stokes breathing?
Cerebral lesion
What lesion causes central neurogenic hyperventilation breathing?
Midline lesion
What lesion causes apneustic breathing?
Pontine lesion
What lesion causes ataxic breathing?
Medullary lesion
What will the pupillary reaction be in a midbrain lesion?
Fixed, midposition
What will the pupillary reaction be in an uncal lesion?
Fixed, dilated
What will the pupillary reaction be in a pons lesion?
Pinpoint
What will the pupillary reaction be in a tectal lesion?
Fixed, hippus
What will the pupillary reaction be in a diencephalic lesion?
Small, reactive
Discuss the GCS for children
Eye opening
- spontaneous (4)
- verbal command (3)
- pain stimuli (2)
- no response (1)
Motor
- spontaneous (6)
- localises pain (5)
- withdrawal on pain (4)
- decorticate, flexion (3)
- decerebrate, extension (2)
- no response (1)
Verbal
- appropriate interaction (5)
- consolable crying (4)
- continuous crying (3)
- inconsolable crying (2)
- no response (1)
What investigations should you always do if you suspect infection?
Blood culture
LP
Urine
What do you suspect in a neurological emergency if you find focal signs?
Tumour
Stroke
Abscess
