traumatic brain injuries Flashcards
Epidural
subdural
lens shaped - obeys suture lines
more diffuse
contusions more like to happen in
frontal and temporal lobes
goal in severe traumatic brain injury is to
maintain cerebral perfusion pressure by reducing ICP
CPP = MAP - ICP
how do you reduce ICP
- prevent hyperthermia
- seizures
- hyperglycemia
as ICP goes up what 2 fluid compartments decrease
venous blood and CSF
most common way to measure ICP is using
an external ventricular device
How low should ICP be maintained and
CPP
ICP < 20-25 (N = 10)
CPP < 50-70
what is better to use if a patient as increased ICF/ISF
give them hypertonic saline rather than mannitol
If you have an increase in venous or arterial blood what d you do
Venous - elevate the head
arterial - hyperventilate - mild
why do you hyperventilate when you have increased arterial blood in the brain
decrease Co2
decrease CBF
Decrease CBV
2nd line options for management of ICP
1- Barbiturates
2- Hypothermia
3- decompressive craniotomy
How do the barbiturates act?
lower cerebral metabolism
Dec CBV Dec ICP
how can you raise MAP in case of controled ICP
norepi
