Acute Brain Injury: Symptoms, Causes, and Manifestations, Quizzes of Photography

Download Acute Brain Injury: Symptoms, Causes, and Manifestations and more Quizzes Photography in PDF only on Docsity! TERM 1 Acute Brain injury Symptoms: Primary brain injury: DEFINITION 1 Occurs as a direct result of the initial insult. TERM 2 Acute Brain injury Symptoms: Secondary brain injury DEFINITION 2 Refers to progressive damage resulting from the bodys physiologic response to the initial insult. TERM 3 Ischemia DEFINITION 3 - Contributing factor of brain injury-Occurs when the blood supply is inadequate to meet metabolic needs.- Results in:mitochondrial failure, ATP depletion, and accumulation of intracellular calcium ions TERM 4 Cellular Energy Failure DEFINITION 4 -Inadequateenergy supply leads to deterioration of ion gradients- Neuronal tissue is highlysensitiveto oxygen deprivation, because it has great demand for ATP and limited capacity for anaerobic metabolism during ischemia- TERM 5 Excitatory Amino Acids DEFINITION 5 - Excessive release of excitatory amino acids, like glutamate, leads to calcium overload during acute brain injury.- Calciumoverload leads to cell dysfunction, membrane damage, and cell necrosis. TERM 6 Reperfusion Injury DEFINITION 6 - Occurs when blood flow is reintroduced to previously ischemic but viable cells.- Return of oxygen brings potential for oxygen free radical formation that damage cell structure and the flow allow inflammatorily cells to invade the area.- Inflammatorycells increase edema, block vessels, and contribute to free radical production. TERM 7 Abnormal Auto regulation DEFINITION 7 - Excessive cerebral blood flow cause cerebral edema - Blood flow achieves appropriate flow to meet metabolic needs despite changes in blood pressure and metabolism.- Effective over a range of MAP (mean arterial pressure) from 50 to 150 mm Hg.- Hypoxia,high PaCO2 result in dilation of cerebral vessels.- Hyperventilationlow Paco2 results in cerebral vasoconstriction TERM 8 Increased Intracranial Pressure (ICP) DEFINITION 8 - NormalICP ranges from 0 to 15 mm Hg. - Transientincreases are tolerated, but chronically increased ICP results in compression of vessels and brain tissue, leading to cellular ischemia and brain damage- Pressurein the cranium is a product of the volume of brain tissue, blood, and CSF.- Common causes: stroke, tauma, tumors, edema TERM 9 Increased Intracranial Pressure (ICP): Brain Compression DEFINITION 9 - Common cause of ICP: brain swellingEdema resultsfrom changes in vascular competency that leads to transudation of fluid into intercellular spaces (vasogenic), or from cellular swelling (cytotoxic) owing to a deficiency in cellular ATP.- ICPcan injure brain tissue by compressing blood vessels and limiting perfusion TERM 10 Increased Intracranial Pressure (ICP): Herniation DEFINITION 10 Protrusion of brain tissue through openings in the supporting dura of the brain TERM 21 Epidural hematomas DEFINITION 21 Associated with skull fracture and progress rapidly because they are arterial in origin. TERM 22 Subdural hematomas DEFINITION 22 Asssociated with shearing of bridging veins and may develop slowly. TERM 23 Traumatic subarachnoid hemorrhage DEFINITION 23 Due to rupture/trauma to bridging veins, similar to subdural bleeding. TERM 24 Secondary Injury DEFINITION 24 -Consequence of the bodys response to the primary injury.- Initiated by traumatic brain injury, resulting in ischemia, increased ICP, and altered vascular regulation- Uncontrolled hemorrhage can lead to hypervolemia that leads to ischemia.- Concomitant injuries and cardiopulmonary impairment may contribute. TERM 25 Management of head injury DEFINITION 25 -Detecting and managing surgical lesions and reducing brain damage from secondary injury.- Normovolemia, normothermia (or mild hypothermia), normal glucose level, and normal Pao2 and Paco2 values are recommended for most patients.-In those with high ICP, diuretics, hyperventilation, and drug-induced coma may be tried.-Open head injuries constitute a risk for CNS infections, and prophylactic antibiotics may be used. TERM 26 Stroke: Epidemiology DEFINITION 26 - 3rd leading cause of death in US-Sudden onset due to cerebrovascular disease.- Common cause: trhombosis, embolization and intracranial hemorrhage- S/sdepend on the vessel occluded: internal carotid, anterior cerebral, middle cerebral, or posterior cerebral artery- Common manifestations: contralateral motor and sensory loss, aphasia, and contralateral visual field loss. TERM 27 Ischemic Stroke DEFINITION 27 -Sudden blockage of artery by a thrombus or embolus produces acute ischemia, if ischemia continues for minutes it leads to irreversible cellular damage.- Penumbra: surrounds the infarct is a larger area of ischemic but viable cells-Thrombotic strokes are associated with atherosclerosis and hypercoagulable states TERM 28 Hemorrhagic Stroke DEFINITION 28 - Associated with uncontrolled hypertension. -Intracranial hemorrhage occurs within the brain parenchyma with severe and long-standing hypertension- Occur in the basal ganglia and thalam-If stroke is large it can lead to ICP, which leads to herniation and death. TERM 29 Treatment DEFINITION 29 - Therapy with thrombolytic agents may limit infarct size in patients with ischemic stroke. - Minimize infarct size and preserve neurologic function- Anticoagulation therapy is often used TERM 30 Stroke Sequelae DEFINITION 30 Associated with long-term deficits in motor, sensory, language, and cognitive abilities. Initially, affected muscles are flaccid, with spasticity occurring after about 6 weeks. TERM 31 Motor and Sensory Deficits DEFINITION 31 - Characterized by flaccidity (It is decrease in or absence of muscle tone in the affected extremities)-Sensory impairment affects the same area as motor paralysis. TERM 32 Language Deficits DEFINITION 32 - Aphasia: inability to understand or express speech- Concentration, memory, and reasoning may be impaired. TERM 33 Cognitive Deficits DEFINITION 33 Commonly evidenced as language deficit, impaired spatial relationship skills, short-term memory impairment, and poor judgment TERM 34 Cerebral Vessel Disorders DEFINITION 34 -- -Causes of subarchoid hemorrhage: Cerebral aneurysms and arteriovenous malformations - Aneurysm have high mortality rate - - Blood in the subarchonoid space causes: headache, stiff neck and secondary cerebral vasospasm - - - Vasospasm leads to cerebral ischemia TERM 35 Cerebral Aneurysms DEFINITION 35 - Lesions of an artery that lead to dilation and ballooning of the vessel. - Treatment:surgical stabilization by clip ligation and aggressive management of secondary vasospasm.- S/s:High blood pressure, acute alcohol intoxication, and recreational drug (cocaine) TERM 46 Dementia DEFINITION 46 -Characterized by progressive deterioration and continuing decline in memory and other cognitive functions.-Causes: alcoholism, intracranial tumor, normal pressure hydrocephals, Parkinson disease, lewy body disease, Huntington disease, multiple sclerosis, pick disease, Creutzfeldt- Jakob disease and bovine spongiform encephalopathy-Alzheimer disease is the most prominent cause of dementia (50-60% of cases) TERM 47 Alzheimer disease DEFINITION 47 - Characterized by degeneration of neurons in temporal and frontal lobes, brain atrophy, amyloid plaques, and neurofibrillary tangles.-The synthesis of brain acetylcholine is deficient.- Genetic factors and environmental triggers are suspected.- S/s:agnosia lack of insight into their cognitive deficiencies. - TERM 48 Parkinson Disease DEFINITION 48 - Dopamine deficiency in the basal ganglia (substantia nigra, caudate, and putamen) is associated with symptoms of motor impairment.- Difficulty initiating and controlling movements results in akinesia, tremor, and rigidity.-Attempts to passively move the extremities are met with cogwheelrigidity- S/s: lack of movement, loss of facial expression, drooling, propulsive gait, and absent arm swing. TERM 49 Treatment for parkinsons: DEFINITION 49 - Restoring brain dopamine levels or activity by administration of dopamine precursors, dopamine agonists, monoamine oxidase inhibitors, and anticholinergics. TERM 50 Cerebral Palsy (CP) DEFINITION 50 -One of most common crippling disorders of childhood- Most common type:Spastic CP (70-80% of cases)- Develop in utero, during birth or in infancy- Permanent, nonprogressive damage to motor control areas of the brain.- S/s: spasticity, ataxia, dyskinesia, or a mix of one or more of the three. - - TERM 51 CP: Etiologic factors: DEFINITION 51 -Prenatal infections or diseases of the mother-Mechanical trauma to the head before, during, or after birth-Exposure to nerve damaging poisons; or reduced oxygen supply to the brain. TERM 52 CP: treatment DEFINITION 52 - Varies according to the nature and extent of brain damage.- Muscle relaxants, anticonvulsant drugs, orthopedic surgery, casts, braces, and traction are among the therapies used. TERM 53 Hydrocephalus DEFINITION 53 -Characterized by abnormal accumulation of CSF in the cerebral ventricular system.-Effective treatment: surgical correction employing a shunt.-With increased CSF pressure, brain tissue is flattened against inside of skull, causing damage TERM 54 Cerebellar Disorders DEFINITION 54 - Responsible for coordinated control of muscle action, excitation and inhibition of postural reflexes, and maintenance of balance.-Etiologic factors: abscess, hemorrhage, tumors, trauma, viral infection, or chronic alcoholism.-Clinical manifestations: ataxia, hypotonia, intention tremors, and disturbances of gait and balance. TERM 55 Multiple Sclerosis DEFINITION 55 - Demyelinating disease of the CNS that primarily affects young adults.-Cause: Immunologic abnormalities and environmental factors are suspected.- Demyelination can occur throughout the CNS but most frequently affects the optic and oculomotor nerves and spinal nerve tracts. TERM 56 Multiple Sclerosis: S/s DEFINITION 56 - Slowly progressive: exacerbations and remissions.- Double vision- Weakness- poor coordination,- sensory deficits.- Bowel and bladder control may be lost.- Memory impairment TERM 57 Spina Bifida DEFINITION 57 - Developmental anomaly characterized by defective closure of the bony encasement of the spinal cord (neural tube) through which the spinal cord and meninges may or may not protrude- If there is an external protrusion of the saclike structure, the condition is classified according to extent of neural involvement (e.g., meningocele, myelomeningocele).-Folic acid supplementation taken before conception and during pregnancy decreases risk of neural tube defects. TERM 58 Amyotrophic Lateral Sclerosis DEFINITION 58 - Progressive disease affecting both the upper and lower motor neurons- S/s: Weakness and wasting of the upper extremities, impaired speech, swallowing, and respiration.- In men,between the ages of 40 and 60, more in men than women. - Management:Riluzole (Rilutek) is a glutamate inhibitor TERM 59 Amyotrophic Lateral Sclerosis Clinical manifestations DEFINITION 59 - weakness,- Atrophy,- Cramps,- Stiffness,- Irregular twitching of muscle fibers. TERM 60 Guillain-Barr Syndrome DEFINITION 60 - Characterized by muscle weakness that begins in the lower extremities and spreads to the proximal spinal neurons. - Inflammatory demyelinating disease of the peripheral nervous system-Cause is unknown; however, a postinfectious immunologic mechanism is suspected.