Neurological Disorders Flashcards

Question

What is a epidural hematoma?

Answer 1

- Bleeding between dura and the inner surface of the skull - Compresses dura mater - Most commonly the result of torn arteries – MMA (mini meningeal artery) - Often patient may be unconscious at the scene, followed by a brief lucid interval, then a subsequent LOC - Medical emergency - least common, but most significant

Answer 2

- Blood in the subdural space - A result of tearing of veins - Onset of symptoms may be slower as a result of venous source Classified as: - Acute – within 48 hours of injury - Subacute – within 2 to 14 days after injury - Chronic – weeks or months after minor head injury (very slow bleeding)

Answer 3

``` Bleeding in the subarachnoid space May be a result of: a traumatic force a ruptured cerebral aneurysm an arteriovenous malformation (AVM) ```

Answer 4

Bleeding within the brain tissue itself | Can be a result of traumatic injury, aneurysm AVM, hypertensive injury to blood vessel walls

Answer 5

Bleeding into the ventricles May result from trauma or stroke More common in infants

Answer 6

Ischemic (83%) Caused by thrombotic or embolic blockage of cerebral vessels that stop blood from flowing to cerebral tissue Sudden impairment of cerebral circulation in one or more blood vessels supplying the brain Can affect large or small vessels Hemorrhagic (17%) Caused by ruptured vessel and bleeding into the brain tissue or subarachnoid space

Answer 7

Thrombotic strokes Atherosclerosis causes fatty deposits and plaque formation this leading to arterial stenosis, platelet adhesion and ultimately vessel lumen obstruction Common site of thrombus formation is at the bifurcation of the common carotid artery int eh the internal and external carotid arteries Embolic strokes Common embolus is plaque Embolus forms outside of brain, then detaches and travels through the cerebral circulation where it lodges in and occludes a cerebral artery Risk factors include: Chronic atrial fibrillation, prosthetic heart valves and endocarditis

Answer 8

Brain is extremely sensitive to blood supply and is perfused at the expense of less vital organs Hypoxia leads to cerebral ischemia and temporary neurologic deficits or irreversible damage depends on how long the blood was restricted - The extent of infarction depends on - The location of the occluded artery - The size of the occluded artery - The adequacy of collateral circulation Cell death and permanent changes can occur within 3 to 10 minutes

Answer 9

Cells in the centre of stroke area (core ischemic zone) die almost immediately

Answer 10

Zone of hypoperfusion around the infarcted area | Depends on the amount of collateral circulation present

Answer 11

Rupture of a cerebral vessel causing bleeding into brain tissue Often secondary to hypertension Most common after age 50 Hemorrhage volume is the most important predictor of outcomes Effects depend on the site and extent of bleeding

Answer 12

- Sites where blood vessels have weakened may lead to rupture and bleeding into the surrounding tissue - Brain tissue can become compressed producing ischemia, increased ICP and necrosis of tissue - Cerebral edema develops and can take up to 2 weeks to resolve. - Leading causes of weakened blood vessels are aneurysms and AVMs

Answer 13

``` Hypertension! Cardiovascular disease and atrial fibrillation Diabetes mellitus Immobility Prior stroke, carotid stenosis, history of TIAs Stress Hyperlipidemia Cigarette smoking Heavy alcohol consumption Cocaine use High-estrogen contraceptive combined with hypertension Advancing age Family history of stroke ```

Answer 14

``` Headache Vomiting Seizures Changes in mental status Motor changes Communication ```

Answer 15

Transient hemiparesis, loss of speech, and hemisensory loss | Develops over minutes to hours or days

Answer 16

Occurs rapidly, typically whilst awak Severe occipital and nuchal headaches Vertigo or syncope Paresthesias and transient paralysis

Answer 17

Hemiparesis (weakness) or hemiplegia (paralysis on one side of the body) Aphasia – deficit in the ability to communicate Wernicke’s: speech comprehension Broca’s: speech production Dysarthria – imperfect articulation Dysphagia – difficulty swallowing Apraxia – difficulty making skilled movements Visual changes – depth and visual perception, homonymous hemianopia (visual loss in the same half of the visual field of each eye) Horner’s syndrome – paralysis of the sympathetic nerves to the eye Agnosia – inability to recognize familiar objects Unilateral neglect – inability to respond to stimulus on the contralateral side Sensory deficits Behavioural changes incontinence

Answer 18

Identify stroke early Maintain cerebral oxygenation – patent airway, elevate head, oxygen Restore cerebral blood flow (ischemic stroke) – thrombolytic therapy Prevent and manage complication – bleeding, cerebral edema, stroke recurrence, aspiration Rehabilitation (look at functional deficits and find ways to improve their quality of life)

Answer 19

Sudden, brief episodes of neurologic dysfunction caused by temporary, focal cerebral ischemia Recovery is complete – most TIAs last 5-20 minutes OFTEN SERVES AS A WARNING SIGN OF AN IMPENDING STROKE 1/3 of all people with untreated TIAs experience a stroke within 5 years

Answer 20

Pathophysiology Similar to ischemic stroke, only transient Manifestations Develop based on the area of the brain affected Management Prevent progression of the TIA into a stroke Determine the cause Identify and decrease modifiable risk factors

Neurological Disorders Flashcards

(44 cards)