TBI

Question 1

most common herniation?

Answer 1

subfalcine

Question 2

compression of what in a subfalcine herniation?

Answer 2

ACA- focal defecit of lower limb

Question 3

uncal herniation compresses what?

Answer 3

ipsi oculomotor nerve, ipsi PCA,, contralateral cerebral peduncle

oculomotor sx

Question 4

ways to decrease blood flow to brain during herniation?

Answer 4

hyperventilation and cooling

Question 5

side effect of hyperventilation during herniation?

Answer 5

ischemia due to vascoconstriction

Question 6

mechanism of mannitol and hypertonic saline in herniation?

Answer 6

increasing tonicity of blood pulling water from the brain and drain more fluid out

Question 7

AED post severe TBI?

Answer 7

phenytoin preferred, for 7 days which reduced the risk of stroke

Question 8

seizure post TBI prognosis?

Answer 8

no worse neurologic recovery

Question 9

what intervetnion can decrease mortality in TBI

?

Answer 9

TXA, based on the CRASH-3 trial

Question 10

goal Na 150-155 can lead 2to what in TBI?

Answer 10

less neurosurgical procedures, dec ICU LOS

Question 11

severe TBI GCS?

Answer 11

<7

Question 12

TBI GCS 3-8 with normal head CT, who gets a EVD?

Answer 12

> 40 yo, SBP <90, posturing

Question 13

TBI GCS 3-8 abnomal head CT?

Answer 13

EVD

Question 14

spinal cord injury MAP goal?

Answer 14

> 80

Question 15

cerebral perfusion pressure? goal?

Answer 15

MAP - ICP, >60- may need to inc MAP to maintain if high ICP