Term
|
Definition
Indications are related to location and cause of raised pressure.
Any altertations in LOC
Decrease in Glasgow Coma Scale
Cushing's triad is a late response and indicates severe IICP. |
|
|
Term
|
Definition
Maintaining cerebral perfusion
Decrease ICP
Maintain optimal neurological function
Ready for rehabilitation |
|
|
Term
|
Definition
Mannitol
Immediately expands the volume of plasma and increases cerebral blood flow and oxygen delivery. |
|
|
Term
| Complications of Head Injury |
|
Definition
Cerebral edema
Stress ulcers
Seizures
Infections
Acute hydrocephalus
SIADH
Cardiac dysrhythmias
Neurogenic pulmonary edema
Subarachnoid hemorrhage/aneurysms
Altered behavior
Post-trauma response |
|
|
Term
|
Definition
| An increase in the fluid content surrounding the tissues of the brain, such as in the extracellular spaces or the white matter, or within the cells. |
|
|
Term
|
Definition
Osmotic diuretics
Head of bed 30 degrees
Maintain patent airway
Monitor ICP |
|
|
Term
Cerebral Perfusion Pressure
CPP |
|
Definition
CPP=MAP-ICP
The amount of blood flow from the systemic circulation required to provide adequate oxygen and glucose for brain metabolism.
When ICP and MAP are equal there is no CPP and brain perfusion ceases.
Crucial to maintain control of both ICP and MAP.
CPP goal = remember 70 |
|
|
Term
|
Definition
| Cerebral edema and brain swelling |
|
|
Term
|
Definition
Brain moves enough to shear or tear axons secondary to trauma.
Often there is no macroscopic abnormality noted on CT.
Detected on the basis of neuropsychological tests. |
|
|
Term
|
Definition
| Injury at point of contact and on the opposite side of the skull. |
|
|
Term
|
Definition
| Head wounds made by foreign bodies or bone fragments from a skull fracture. Damage done to brain itself or to vessels resulting in a hematoma. |
|
|
Term
|
Definition
Between skull and dura
10% of severe head injuries
Usually associated with skull fractures
Injury to cerebral blood vessels under fracture
Bleeding continues and clot forms, seperating skull from dura. |
|
|
Term
Epidural Hematoma
Manifestations
and
Prognosis |
|
Definition
Brief period of disrupted consciousness followed by a lucid period which is then followed by a rapidly deteriorating consciousness.
Rapid dx with CT followed by treatment is detrimental as injury is usually minor and with treatment, prognosis is usually good. |
|
|
Term
|
Definition
Between the dura and the outer arachnoid membrane.
Bridging veins, venous blood flow.
Slow formation of hematoma.
|
|
|
Term
Subdura Hematoma
Manifestations |
|
Definition
Produces symptoms within 24 hours of injury.
Delayed and patients may not associate them with a head injury.
IICP->headaches, vomiting, blurred vision.
2-10 days after the primary event
dx: CT and MRI
tx: Surgical to remove clot, antibiotics, and seizure prophylaxis. |
|
|
Term
|
Definition
Anticipate orders for labs, radiology, IVF, Mannitol, anti seizure meds, frequent VS and neuro checks.
Assessment:
Glasgow Coma Scale
Check Pupils
Vital Signs
Watch trends and report changes |
|
|
Term
|
Definition
Ventriculostomy-monitor and drain CSF if needed
Subarachnoid screw
Subdural/Epidural Catheter
Intraparenchymal of a Fiberoptic Transducer Tipped Catheter |
|
|
Term
| Hypotension and brain injury |
|
Definition
BAD! Often associated with bad outcomes.
Avoid!
Maintain MAP.
Avoid hypotonic fluids.
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|
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