Test 4: cerebral Flashcards
are commonly observed in poisoning (opiate or barbiturate) or brain stem dysfunction
Pinpoint pupils
Are often seen after seizures and may involve one side
Widely dilated and reactive pupils
Suggested paralysis of CN III secondary to pressure from herniation of the brain through the tentorium
widely dilated and fixed pupils
Usually suggests a lesion on the same side
unilateral fixed pupils
Usually imply brainstem damage if present more than 5 minutes
Bilateral fixed pupil
Occur in hypothermia, anoxia, ischemia, poisoning with atropine like substances, or prior instillation mydriatic drugs
Dilated and nonreactive pupils
Occurs with sever dysfunction of the cerbral cortex or with lesions to corticospinal tracts above the brainstem
Flexion posturing (decorticate)
Is a sign of dysfunction at the level of the midbrain or lesions to the brainstem
Extension (decerebrate)
Conscious sedation drugs
Chloral hydrate
IV sodium Pentobarbital (nembutal)
IV fentanyl (sublimaze)
IV or intranasal midazolam (versed)
Injuries that occur at a time of trauma
Skull fracture
Contusions
Intracranial hematoma
Diffuse injury
Are a single fracture line that starts at the point of maximum impact and spreads; however they do not cross suture lines
Linear fracture
Are those in which the bone is locally broken, usually into sever irregular fragments that are pushed inward
depressed fracture
Consist of multiple associated linear fractures, they usually result from intense impact often from repeated blow, they may suggest child abuse, particularly if they occur in the occipital lobe
Compound fracture
Involve the bones at the base of the skull, is a serious head injury , check for CSF leakage, meningitis is a risk with CSF leakage
Basilar fracture
separation of cranial bones at a suture
Diastatic
bruising at the site of impact
coup
bruising at a site far removed from the point of impact
contrecoup
definitive test for bacterial meningitis
LP
long term complication of a brain abscess
seizures
common complication of TB meningitis
hydrocephalus
causes of seizures
Infection Tumors Systemic diseases Drugs Trauma
treatment for infantile spasms
ACTH
treatment for febrile seizures if on going
Diazepam (rectal)
