Stroke and TBI from internship 1 Exam Questions and Answers

Stroke and TBI from internship 1 Exam Questions and Answers Intraparenchymal hemorrhage (IPH) - Answer-An intraparenchymal hemorrhage is a blood clot that develops in the brain. Intraparenchymal hemorrhage is one form of intracerebral bleeding in which there is bleeding within brain parenchyma. The other form is intraventricular hemorrhage. Intraparenchymal hemorrhage accounts for approx. 8-13% of all strokes and results from a wide spectrum of disorders. It is more likely to result in death or major disability than ischemic stroke or subarachnoid hemorrhage, and therefore constitutes an immediate medical emergency. Intracerebral hemorrhages and accompanying edema may disrupt or compress adjacent brain tissue, leading to neurological dysfunction. Substantial displacement of brain parenchyma may cause elevation of intracranial pressure and potentially fatal herniation syndromes. Intraparenchymal hemorrhage may occur suddenly without any apparent cause, according to the Mayo Clinic. In such cases, the affected individuals normally have weakened blood vessels as a result of long term hypertension. Other causes of intraparenchymal hemorrhage include tumors, anticoagulant medication and brain lesions, according to the Mayo Clinic. The Mayo Clinic notes that, as with most brain lesions, intraparenchymal hemorrhage may present with various symptoms, such as severe headache, seizures, memory loss and coma in cases that are severe. Parenchyma - Answer-Parenchyma refers to the functional tissue in the brain that is made up of the two types of brain cell, neurons nad glial cells. Damage or trauma to the brain parenchyma often results in a loss of cognitive ability or even death. Intraventricular hemorrhage - Answer-Intraventricular hemorrhage, also known as intraventricular bleeding, is a bleeding into the brain's ventricular system, where the cerebrospinal fluid is produced and circulates through towards the subarachnoid space. It can result from physical trauma or from hemorrhaging in stroke. Cerebral embolus (CE) - Answer-is composed of bits of matter (blood clot, plaque) formed elsewhere and released into the bloodstream, traveling to the cerebral arteries where they lodge in a vessel, producing occlusion and infarction. The most common source of CE is disease of the cardiovascular system. Intracerebral hemorrhage (IH) - Answer-is caused by rupture of a cerebral vessel with subsequent bleeding into the brain. Primary cerebral hemorrhage - Answer-(nontraumatic spontaneous hemorrhage) typically occurs in small blood vessels weakened by atherosclerosis producing an aneurysm. Subarachnoid hemorrhage (SH) - Answer-occurs from bleeding into the subarachnoid space typically from a saccular or berry aneurysm affecting primarily large blood vessels. Arteriovenous malformation (AVM) - Answer-is another congenital defect that can result in stroke. AVM is characterized by a tortuous tangle of arteries and veins with agenesis of an interposing capillary system. The abnormal vessels undergo progressive dilation with age and eventually bleed in about 50% of cases. Clinical signs of elevating intracranial pressure (ICP) - Answer-include decreasing level of consciousness (stupor and coma), widened pulse pressure, increased heart rate, irregular respirations (Cheyne-Stokes respirations), vomiting, unreacting pupils (cranial nerve [CN] III signs), and papilledema. Cerebral edema is the most frequent cause of death in acute stroke and is characteristic of large infarcts involving the middle cerebral artery and the internal carotid artery. Transient ischemic attack (TIA) - Answer-the temporary interruption of blood supply to the brain. Symptoms of focal neurological deficit may last for only a few minutes or for several hours, but by definition do not last longer than 24 hours. After the attack is over there is no evidence of residual brain damage or permanent neurological dysfunction. TIAs may result from a number of different etiological factors, including occlusive episodes, emboli, reduced cerebral perfusion (arrhythmias, decreased cardiac output, hypotension, overmedication with antihypertensive medications, subclavian steal