Pathologies (Lecture #6)

Question 1

conditions that cause increased intracranial pressure

Answer 1

hemorrages
edema due to
-trauma
-lack of blood flow
-lack of oxygen
tumors
infection

Question 2

common symptoms of increased intracranial pressure

Answer 2

headache
irritability followed by sleepiness
nausea and vomiting
visual loss
double vision

Question 3

compression of midbrain reticular formation causes

Answer 3

decreased level of consciousness

Question 4

swelling of CN II causes

Answer 4

loss of visual acuity/visual fields

Question 5

CN IV stretched causes

Answer 5

loss of eye abduction

Question 6

tx of elevated ICP

Answer 6

raise head of bed to 30 degrees
intubate/control breathing
mannitol
ventricular drainage
induce coma
menicraniectomy (remove part of skull)

Question 7

types of brain herniation

Answer 7

subfalcine
central
transtentorial (uncal)
tonsillar

Question 8

subfalcine herniation

Answer 8

cingulate gyrus herniates under falx

Question 9

central herniation

Answer 9

both hemispheres displace downward thru tentorial notch
brainstem gets displaced downward
seen in hydrocephalus

Question 10

transtentorial (uncal) herniation

Answer 10

medial aspect of temporal lobe is pushed downward thru tentorial notch and squishes midbrain

Question 11

tonsillar herniation

Answer 11

tonsils (caudal-most part of the cerebellum) get pushed down through foramen magnum
medulla gets squished

Question 12

signs of subfalcine herniation

Answer 12

personality change

akinetic mute

Question 13

what can tonsillar herniation cause

Answer 13

respiratory arrest and death

Question 14

what can central and transtentorial herniation cause

Answer 14

coma and death

Question 15

types of intracranial hemmorage

Answer 15

epidural hematoma
subdural hematoma
subarachnoid hemorrhage
intracerebral hemorrhage

Question 16

what typically causes epidural hematoma

Answer 16

blow to head (usually to temporal area)
fall
MVA

Question 17

what happens in epidural hematoma

Answer 17

middle meningeal artery bleeds into epidural space

Question 18

what typically causes acute subdural hematoma

Answer 18

MVA

shaken baby syndrome

Question 19

what happens in acute/chronic subdural hematoma

Answer 19

tearing of bridging veins, usually comorbid with intracerebral hemorrhages

Question 20

what typically causes chronic subdural hematoma

Answer 20

brain shrinks as you get older, stretching bridging veins and making them more susceptible to damage

Question 21

what happens in subarachnoid hemorrhage

Answer 21

rupture of aneurysm in one of the arteries in subarachnoid space

Question 22

what will pts with subarachnoid hemorrhage typically complain of

Answer 22

worst headache ever

stiff neck

Question 23

what happens in traumatic intraparenchymal hemorrhage

Answer 23

blood vessels within cerebral hemispheres, brainstem, or cerebellum bleed esp at temporal and frontal poles
contusions
hematomas

Question 24

signs of traumatic intraparenchymal hemorrhage

Answer 24

personality changes
executive fxn
emotional changes
memory problems

Question 25

cause of spontaneous intraparenchymal hemorrhage

Answer 25

rupture of small vessels deep within the brain

typically caused my hypertension

Question 26

diffuse axonal injury

Answer 26

disruption of axons deep within brain

seen as small hyperintensities in white matter of cerebral hemispheres and brainstem

Question 27

hydrocephalus

Answer 27

blockage of flow of CSF

fluid accumulates in ventricles and/or subarachnoid space

Question 28

causes of noncommunicating hydrocephalus

Answer 28

congenital blockage of cerebral aqueduct
blood in ventricular system
tumor compressing ventricular system
edema compressing ventricular system

Question 29

causes of communicating hydrocephalus

Answer 29

meningitis damages arachnoid granulations

subarachnoid blood damages arachnoid granulations

Question 30

meningitis

Answer 30

infection of pia and arachnoid layers of meninges

symptoms: headache, stiff neck, photophobia

Question 31

encephalitis

Answer 31

infection of brain almost always caused by virus

symptoms: headache, seizures, confusion