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Clinical Neuroscience > Path- 3: Edema, ICP, herniations > Flashcards

Path- 3: Edema, ICP, herniations Flashcards

1
Q

What causes vasogenic edema?

A

BBB disruption, resulting in focal or generalized increase in permability

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2
Q

What causes cytotoxic edema?

A

increase in intracellular volume

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3
Q

Where does interstitial edema (hydrocephalus) typically occur?

A

Around the lateral ventricles

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4
Q

With ischemia, what happens to the white matter?

A

It becomes more edematous

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5
Q

Why does the white matter become more edematous?

A

increase in salt because of pump inhibition

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6
Q

What produces CSF?

A

Choroid plexi

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7
Q

How much CSF is produced per day?

A

500mL

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8
Q

Where is CSF reabsorbed?

A

Arachnoid villi

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9
Q

What happens if there is an obstructuon ot flow of the CSF int he ventricles?

A

noncommunicating hydrocephalus

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10
Q

What causes noncommunicating hydrocephalus?

A

congnetial malformation, neoplasms, inflammation or hemorrhage

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11
Q

Wehre is the most common location of obstruction to cause noncommunicating hydrocephalus?

A

Aqueduct of Sylvius (IVF)

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12
Q

What causes ivf closure?

A

typically congentical malformations (viral ependymitis during engrogenesis)

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13
Q

What defines ICP?

A

increase mean CSF pressure greater than 200 mmH2O with pt recumbent

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14
Q

What would happen if ICP becomes devere?

A

Brain herniation

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15
Q

What is a subfalcine (cingulate) herniation?

A

asymmatric expanson of the cerebral hemispheres displaces the cingular gyrus under the faux cerebri

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16
Q

What is papilledema?

A

the edematous optic papillar protrude forward into the vitreous humor chamber

17
Q

What are the physiological consequences of an increase of ICP > 30mmHg?

A

decrease in CBF (viscious cycle because cerebral ischemia causes an increased ICP)

18
Q

What are the Sx of an icnreaase of ICP > 30mmHg?

A

headache, nausea/vomiting, papilledema, focal neurological deficits, ALOC, cushings response (increase in ICP with bradycardia)

19
Q

What happens in transtentorial (uncinate) herniation?

A

medial aspects of the temporal lobe are compressed ahgainst the tenorium cerebelli –> herniate.

20
Q

Sx of uncinate herniation?

A

Pupillary dilation and ocular movement impairment on side of lesion (remember it compresses III ipsilaterally), ipsilateral hemiparesis (b/c of CL cerebral preduncle compression)

21
Q

What types of hemmorages are associated with uncinate herniations?

A

hemorrhages in pons and midbrain because of the tearing of the penetrating veins and arteries supplying under brainstem.

22
Q

What happens in a tonsilar heerniation?

A

Displacement of the cerebellum through the foramen magnum. LIFE THREATENING b/c of compression of CV and resp center compression.

23
Q

What is the Tx of a tonsilar herniation?

A

lumbar puncture

Clinical Neuroscience (12 decks)

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