Intracranial hemorrhage's goal for treatment?
Stop bleeding. Decrease icp.
Subdural hematoma?
bleeding between covering of brain (dura) and
... [Show More] surface of brain. Compress brain tissue , leadin to brain dead. Most pt do not recover.
Epidural hematoma?
covering of the brain (dura) peel away from skull (from skull fracture). Wake up and die. Changes in vital signs are late signs.
SubArachnoid hemorrhage (SAH)?
aneurysm of artery in brain, causing rupture. This is a type of hemorhagic stroke. Risk for repeated bleeding is 35% within. First 14 days post first bleed. Vasospasm is a common complication of SAH. Cerebral angiogram can dx cerebral aneurysm. A ruptured aneurysm has a risk for death of 40% , 08% disable after rupture.
Normal ICP for adult?
less than 15mmHg. When treating high ICP, the goal is to be 20 mmHg ICP.
What is cushing's triad?
three symptoms that indicate brian damage from high ICP. BRADYCARDIA, RESP DEPRESSION, HYPERTENSION.
What factors increase ICP?
suction, any stimulations.
Glascow score of 5 indicate?
...
Cerebral angiogram?
visualize cerebral blood flow and blood vessels. Can remove clot in bv at time of process. Insertion of dye through femoral artery. Pt lies flat. Indicated for: atherosclerosis, dissection, tumor, aneurysm, av malformation, stroke. Not for kidney failure, bleeding issue, allergic to dye (iodine& shellfish). Cerebral angiogram can dx cerebral aneurysm. A ruptured aneurysm has a risk for death of 40% , 08% disable after rupture.
Av malformation?
l connection between artery and vein without capillary bed between in brain blood vessels. Leading to high pressure in veins (as vein is receiving blood too quick!-> weaken bv-> risk aneurysm.
WHY IS AVM BAD?
1 risk of aneurysm rupture. 2 enlarged avm will put pressure on surrounding brain. 3 cells that only gets oxy from capillary bed will die.
Types of AV MALFORMATION?
dural fistula, venous malformation, cavernoma, capillary telangiectasia.
two locations of AVM?
BRAIN & SPINE.
treatment for avm?
embolization - deliver glue/ obstructive materials into avm, thus, blood cant flow into avm to cause rupture.
what test is used to locate what part of the brain is damaged by seizure or stroke. this test combines both neuroimaging anf neuropsychological tests?
wada test- inject barbiturate into carotid artery to shut down one brian hemisphere and evaluate the opposite hemisphere..
How to know if a person will be allergic to angiogram dye?
allergic to iodine and shellfish.
A pt with cerebral aneurysm is dx. What can the medical team do to secure it in preventing rupture of the aneurysm?
clipping , endovascular coiling.
What is the procedure of opening the skull?
craniotomy.
What is clipping?
clip at the neck of aneurysm to block normal blood floe from entering; thus, stop it from stretching further and eventually rupture.
What is endovascular coiling?
fill aneurysm with spiral coil to stop blood from filling the aneurysm; thus, prevent high blood pressure from rupturing. Post coiling : extremity straight, neuro check, watch for stroke.
Carotid stenting?
place a stent to keep carotid artery open. Complications: increase risk for stroke by 10%. , Mi 5%, bleeding, formation of clots in stent.
What cause vasospasm post cerebral stenting?
breakdown of hemoglobin in the subarachnoid space, creating inflammatory response, impairing autoregulation. Causing ischemic and infarction. S/S: decrease LOC. Focal/local deficit (ex: speech, vision, hearing probs).
Transcranial doppler (TCD)?
ultrasound that measures velocity of blood flow in brain.
Perfusion CT?
IMAGING THAT SHOWS PERFUSION AREAS OF BRAIN.
WHAT IS IN A NEURO ASSESSMENT?
Pupil size, shape, equality and reactivity, Level of consciousness, orientation and appropriateness, sensory and motor function, visual changes, cranial nerve function, intracranial and cerebral perfusion pressures, ventriculostomy drainage. neurological status of this patient population may wax and wane throughout the period of vasospasm [Show Less]