neurological injuries/illnesses Flashcards
brain death
no motor response, no brainstem reflexes
- negative dolls eye reflex
vegetative state
brainstem maintenance, hypothalamic function, no awareness of self or surroundings
2 outcomes of global ischemia
watershed infarcts and reperfusion injuries
monroe-kellie hypothesis
displacement of fluid contents being a reduction in venous blood flow and CSF content
cushing’s triad
a sign of high ICP
- hypertension
- bradycardia
- irregular respirations
vasogenic cerebral edema
BBB compromised which causes inflammation leading to high ICP
cytotoxic cerebral edema
increase intracellular fluid shift which causes ischemia leading to a high ICP
ischemic CVA
caused by a thrombus/embolus and cause 80% of all strokes
TIA
a warning of a CVA and only present with ischemia
thrombectomy
treatment of ischemic CVA
- blood clot removed via suction through catheter insertion
angioplasty
treatment of ischemic stroke
- stent inserted and balloon blown up to widen vessel
hemorrhagic stroke
1st s&s will be headache, vomiting high BP with sudden onset
hemorrhagic stroke treatment
hypertonic NS (3%NaCl) , mannitol (osmotic diuretic)
AVM
characteristic of slow onset of neuro deficits
- steals blood flow from surrounding area d/t no capillary network
sign of aortic aneurysm
bruits
epidural hematoma
between dura (protective brain layer) and skull
common cause of epidural hematoma
skull fracture
subdural hematoma
between dura (protective brain layer) and subdural space (just below protective layer near brain)
common cause of subdural hematoma
accel/decel injuries
characteristic of acute hematoma
high morbidity and mortality
characteristic of chronic hematoma
very slow onset and due to brain atrophy
main focus when treating hematoma
decrease ICP
- do this through osmotic diuretic and antihypertensives
brain parenchyma infection
encephalitis
spinal cord infection
myelitis
most common cause of infection
bacteria
type of infection that is less fatal
viral/viruses
purulent meningitis
bacterial
lymphocytic meningitis
viral
highest mortality meningitis bacteria
strep.pneumoniae
- 34%
meningitis antibiotics
amoxicillin, vancomycin, 3rd gen cephalosporins
- add in dexamethasone as treatment
metastatic cancer/tumors
tumor starts in one tissue but spreads to others
alkylating agents (DNA damage)
chemotherapy used for tumors/cancer
- temozolomide
temozolomide
type of chemotherapy
idiopathic seizure
genetic origin with no known cause
symptomatic seizure
caused by a brain injury
focal seizures
affect group of neurons in one hemisphere
generalized seizures
both hemispheres involved
status epilepticus
can be any seizure type that progresses to unstoppable state which is life threatening
alzheimers
caused decreased Ach synthesis
- behavioural changes
management of alzheimer’s
increase Ach through cholinesterase inhibitors
parkinsons
caused by lack of dopamine; inability to filter out extra movements
- 2nd most common form of dementia
management of parkinson’s
increase dopamine through dopamine agonists
brainstem
pons, medulla, midbrain
occurence of dreams and nightmares sleep stage
REM
these are all signs of what stage of sleep: fast HR, high BP, fast RR, temp fluctuation, brain resembles wakeful state
REM
insomnia
related to cortisol and have difficulties with initiation and duration of sleep
obstructive sleep apnea
due to collapse of upper airway
- prominent in REM d/t muscle relaxation
central apnea
deficit in brain stem and resp centers where signals aren’t sent
- commonly seen in brain injuries and cerebral edema
schizophrenia positive symptoms
hallucinations, delusions
schizophrenia negative symptoms
withdrawn, apathetic, lack of motivation
neuroleptic malignant syndrome
VS crisis
- hyperthermia, diaphoresis, unstable BP
addiction
forms from ventromedial prefrontal cortex which deals with impulse control
