Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Z Year3 Neuro Conditions > Raised Intracranial Pressure > Flashcards

Raised Intracranial Pressure Flashcards

1
Q

What is idiopathic intracranial hypertension (IIH)?

A

increased ICP in an alert and orientated patient (syndrome of reduced CSF absorption)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are IIH RF?

A
  1. Female sex
  2. Obesity
  3. Endocrine conditions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the causes of general raised ICP?

A
  1. Primary or metastatic tumours
  2. Head injury
  3. Haemorrhage
  4. Infection: meningitis, encephalitis, brain abscess
  5. Hydrocephalus
  6. Cerebral oedema
  7. Statis epilepticus
  8. Idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the symptoms in IIH?

A
  1. Headaches
  2. Pulse-synchronus tinnitus
  3. Transient visual obscuration
  4. Visual loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the signs of IIH?

A
  1. Papilloedmea
  2. Six nerve paraesis
  3. Disturbances in sensory visual function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are raised ICP symptoms?

A
  1. Headache worse on coughing leaning forward
  2. Vomiting
  3. Altered GCS
  4. Low HR and high BP
  5. Pupil changes
  6. Decreased visual acuity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some DDx for IIH?

A

Intracranial structural anomalies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What criteria is used for IIH?

A

Dandy criteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What investigations are used for IIH?

A
  1. Visual field testing (perimetry): enlarged blind spots and other visual field deficiets
  2. Dilated fundoscopy: Frizen grading of papilloedema
  3. Visual acuity: usually normal
  4. MRI of brain
  5. LP at L3/L4: high pressure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What may the MRI brain show in IIH?

A
  • transverse sinus stenosis

- empty stella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What investigations do you do for raised ICP?

A
  1. UandE, FBC, LFTs, serum osmolarity, clotting, blood culture
  2. Consider tox screen
  3. CXR
  4. CT brain
  5. LP if safe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Why do you do a CXR in rasied ICP?

A

any source of infection that may indicate abscess

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management plan in raised ICP?

A
  1. ABC
  2. Correct hypotension
  3. Elevate head 30-40 degrees
  4. If intubated hyperventilate
  5. Osmotric agents can be useful
  6. Corticosteroid not effective in reducing ICP except for oedema surrounding tumours
  7. Other measures
  8. Restrict fluid
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When may a patient need urgent neurosurgery for rasied ICP?

A
  • from focal causes e.g. haematomas by craniotomy or burr hole
  • ICP bolt placed to measure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the management for IIH?

A

1st line: management of factors that may increase ICP: weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When may you use medication for IIH?

A

depends on symptoms

17
Q

What are examples of treatment for the optic effect of rasied ICP?

A
  1. Optic nerve sheath fenestration or CSF shunting: progressive visual loss
  2. Optical prisms (for diplopia of 6th nerve palsy)
18
Q

What medications may you prescribe for symptoms of raised ICP?

A
  1. Pharmacotherapy e.g. acetazolamide and/or furosemide
  2. Analgesia: for persistent headache
  3. Cerebral fluid shunting for headache
  4. NSAIDs: neck pain
  5. Transverse sinus stenting: persistent pulse synchronous tinnitus
19
Q

What are possible complications for raised ICP?

A
  1. Brain herniation

2. Irreversible vision loss

20
Q

What are different types of brain herniation?

A
  1. uncal herniation
  2. cerbral tonsil herniation
  3. subfalcian (cingulate) herniation
21
Q

What is Cushing’s triad seen in ICP?

A
  1. Increased systolic BP
  2. Irregular breathing
  3. Bradycardia
22
Q

What investigations is done in ICP?

A
  1. URGENT HEAD CT

2. NEVER DO LP – can cause brainstem herniation

23
Q

When is ICP worse and why?

A
  • Headache worse in morning
    1. rise in ICP during the night as a consequence of recumbency
    2. a rise in PCO2 during sleep caused by respiratory depression
    3. probably a decrease in CSF absorption
24
Q

Why do you get decreasing GCS with increased ICP?

A

consequence of caudal displacement of the diencephalon and midbrain

25
Q

How do you manage idiopathic rasied ICP?

A
  1. Management of risk factors (e.g. weight loss)
  2. Analgesia (Naproxen, Amitrytpiline)
  3. Or treat underlying cause
26
Q

How can you see papillodema on fundoscopy?

A

not shrap optic disc slightly blurred

Z Year3 Neuro Conditions (34 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions