Pathologies (Lecture #6) Flashcards
conditions that cause increased intracranial pressure
hemorrages edema due to -trauma -lack of blood flow -lack of oxygen tumors infection
common symptoms of increased intracranial pressure
headache irritability followed by sleepiness nausea and vomiting visual loss double vision
compression of midbrain reticular formation causes
decreased level of consciousness
swelling of CN II causes
loss of visual acuity/visual fields
CN IV stretched causes
loss of eye abduction
tx of elevated ICP
raise head of bed to 30 degrees intubate/control breathing mannitol ventricular drainage induce coma menicraniectomy (remove part of skull)
types of brain herniation
subfalcine
central
transtentorial (uncal)
tonsillar
subfalcine herniation
cingulate gyrus herniates under falx
central herniation
both hemispheres displace downward thru tentorial notch
brainstem gets displaced downward
seen in hydrocephalus
transtentorial (uncal) herniation
medial aspect of temporal lobe is pushed downward thru tentorial notch and squishes midbrain
tonsillar herniation
tonsils (caudal-most part of the cerebellum) get pushed down through foramen magnum
medulla gets squished
signs of subfalcine herniation
personality change
akinetic mute
what can tonsillar herniation cause
respiratory arrest and death
what can central and transtentorial herniation cause
coma and death
types of intracranial hemmorage
epidural hematoma
subdural hematoma
subarachnoid hemorrhage
intracerebral hemorrhage
what typically causes epidural hematoma
blow to head (usually to temporal area)
fall
MVA
what happens in epidural hematoma
middle meningeal artery bleeds into epidural space
what typically causes acute subdural hematoma
MVA
shaken baby syndrome
what happens in acute/chronic subdural hematoma
tearing of bridging veins, usually comorbid with intracerebral hemorrhages
what typically causes chronic subdural hematoma
brain shrinks as you get older, stretching bridging veins and making them more susceptible to damage
what happens in subarachnoid hemorrhage
rupture of aneurysm in one of the arteries in subarachnoid space
what will pts with subarachnoid hemorrhage typically complain of
worst headache ever
stiff neck
what happens in traumatic intraparenchymal hemorrhage
blood vessels within cerebral hemispheres, brainstem, or cerebellum bleed esp at temporal and frontal poles
contusions
hematomas
signs of traumatic intraparenchymal hemorrhage
personality changes
executive fxn
emotional changes
memory problems
cause of spontaneous intraparenchymal hemorrhage
rupture of small vessels deep within the brain
typically caused my hypertension
diffuse axonal injury
disruption of axons deep within brain
seen as small hyperintensities in white matter of cerebral hemispheres and brainstem
hydrocephalus
blockage of flow of CSF
fluid accumulates in ventricles and/or subarachnoid space
causes of noncommunicating hydrocephalus
congenital blockage of cerebral aqueduct
blood in ventricular system
tumor compressing ventricular system
edema compressing ventricular system
causes of communicating hydrocephalus
meningitis damages arachnoid granulations
subarachnoid blood damages arachnoid granulations
meningitis
infection of pia and arachnoid layers of meninges
symptoms: headache, stiff neck, photophobia
encephalitis
infection of brain almost always caused by virus
symptoms: headache, seizures, confusion
