Flashcards in Neurologic Emergencies Deck (41):
What is the fifth leading cause of death and disability in the US?
Changes in these levels will cause altered brain funciton
Glucose, oxygen, temperature
If a problem is found in these systems, the brain will be damaged
Cardiac or Pulmonary
What are the types of non-life threatening headaches
Tension headache, migraines, sinus headache
Tension Headache: cause, type of pain, associated symptoms
A tension headache is caused by muscle contractions in the head and neck from stress.
The pain is a squeezing, dull, or ache
There are no associated symptoms
Migraines: cause, type of pain, associated symptoms
A migraine is cause through changes in the blood vessel size at the base of the brain
It is described as pounding, throbbing, pulsating
Usually nausea, vomiting, or change in vision, as well as inability to speak
Sinus Headache: cause, type of pain, associated symptoms
A Sinus Headache is caused by an increase in pressure in the blood vessels in the sinus cavities
Cold like symptoms present, and patients report increased pain when their head moves.
What are the red flags for a patient with a headache?
-Explosive, thunderclap pain
-Older than 50
-Neck stiffness or pain
-Depressed immune system
-Changes in vision
-One side paralysis or weakness
What is bacterial meningitis? Symptoms? What treatment can you provide?
It is a bacterial infection of the meninges that affects the central nervous system.
Patients who complain of a headache, stiff neck, fever, and sensitivity to light should be monitored closely.
You can place your patient in a darkened room and lower the amount of noise to ease comfort
Cerebrovascular Accident is otherwise known as
Reduction in blood flow that results in inadequate oxygen supplied to the cells, and subsequent decrease in proper functionality of cells
Define an Ischemic Stroke
What are the symptoms
An ischemic stroke occurs as a result of a blood clot either through a thrombosis (forms there) or an embolus (travels)
Symptoms are typically very dramatic, including loss of function on the contralateral side of the body.
What are the causes of a blood clot?
Atherosclerosis: calcium buildup forming plaque in the walls of the vessels. Pieces of the clot can also break off and embolus, creating more clots
What are the symptoms of a cerebral embolism?
They can vary from complete paralysis to no symptoms at all
Define a Hemorrhagic Stroke (statistics?)
What are the symptoms?
A hemorrhagic stroke occurs as a result of a burst blood vessel in the brain.
It accounts for 13% of all strokes
The burst blood vessel forms a clot that compresses the adjacent brain tissue, preventing oxygenated blood from getting to it.
Define an Aneurysm.
Why does it happen?
What are the symptoms?
-An aneurysm is a ballooning off of the arterial wall, it is caused by a defect or weakness in the arteries. If left untreated, the aneurysm can burst, leading to a hemorrhagic stroke.
-Sudden onset, severe headache from irritation of blood on the brain tissue.
Define Transient Ischemic Attack
When stroke symptoms resolve on their own in less than 24 hours (ministrokes)
1/3 of patients with a TIA will suffer a stroke soon after
Signs and Symptoms of a Stroke
-Drooping sides of the face or neck
-Change in vision
-Change in speech patterns
-Aphasia or Dysarthria
Left Hemisphere Right Hemisphere
LH: speech issues, inability to link visual stimuli to words, word salad
A typical vitalof a patient with a cerebral hemorrhage is:
High Blood Pressure
What are the conditions that mimic a stroke?
Post-Ictal State (after a seizure)
Subdural or Epidural bleeding
How many people have epilepsy
2-3 million people
Define a Generalized Tonic Clonic Seizure. What causes it? What are the symptoms?
A Generalized Seizure is a burst of electrical activity in both of the hemispheres. This can either result in a loss of consciousness and muscle twitching, or an Absence or Petit Mal seizure, where there is a momentary lapse of consciousness, where they stare off into space.
Define Partial (Focal) Seizure. What causes it? What are the symptoms?
There are two types of partial seizures, both of which stay in one part of the brain.
Simple Seizures: the patient will not experience any changes in their consciousness. They will report dizziness, numbness, slowly spreading muscle twitching, visual changes, and unusual smells of tastes.
Complex Seizures: the patient will experience an altered mental status, they may present with lip smacking, eye blinking, or isolated convulsions.
What is an aura?
A warning sign to a seizure
In a generalized seizure attack, what are the differences in vital signs?
The patient will be in tachycardia, as well as hyperventilating, they will be sweating, and salivating intensely.
How long to Generalized Seizures last?
The muscle convulsions last 1-3 minutes, and the whole seizure lasts 3-5 minutes where the postictal phase lasts anywhere from 5 to 30 minutes.
What are the metabolic causes of seizure?
What are Febrile Seizures?
Seizures that primarily affect children as a result of high fevers.
Why do patients turn cyanotic after seizures
The violent muscle spasms that come with a generalized seizure consumes a lot of oxygen & the cells are not getting enough.
What the Post Ictal State look like?
the patient's muscles become floppy, and their breathing is deep and labored. Their heart rate increases rapidly.
They may present with hemiparesis, but unlike a stroke, it resolves itself.
What are the potential causes of an altered mental state?
What priority is a stroke patient?
High, rapid and immediate transport is needed.
What is the Cincinnati Stroke Scale?
Facial Droop, arm lift, speech
What is the LA Stroke Screen? What do you check?
Age, history, length of symptoms, baseline wheelchair, blood glucose between 60 and 400mg/dL
Facial droop, Grip, Arm Strength (hold arms out, palms up for 10 seconds)
What is the LAG scale?
Consciousness, Arm Drift, Gaze (eyes follow pen)
Score of 5 or 6 indicates likely stroke
What is the FAST?
Facial Droop, Arm Drift, Speech, Time
What is the Glasgow Coma Scale? When should you use it?
It is a method of determining mental status. It should be used in all patients with AMS. A score less than 8 is considered highly dysfunctional.
After __ hours, treatment for stroke becomes ineffective.
Provide oxygen to a ___ patient to maintain an SPO2 value of at least ___%