Neurological Disorders Study Review
dilantin - Ans -an anticonvulsant drug (trade name Dilantin) used to treat epilepsy
and that is not a sedative
Increased Intracranial Pressure (IICP) Definition - Ans -- refers to the pressure of the
subarachnoidal fluid that is present in the space between the skull and the brain. Any
disruption of cerebral circulation can lead to IICP. The major complication of IICP is brain
stem herniation. Normal ICP is 0-15 mm/hg. Mild increase is 16-20, a moderate increase is
21-30, a severe increase is 31-40 and any reading above 40 is considered a very severe
increase
Assessment of IIP (7) - Ans -1. level of responsiveness
2. change in behavior (early signs)
3. changes in vital signs (late signs)
4. headache
5.vomiting
6. Glascow Coma scale
7. Neuro Assessment
Level of responsiveness IIP - Ans -AKA level of wakefulness, comatosed
Changes in behavior IIP (early signs) - Ans -AKA mental acuity
- terms to describe: restlessness, exaggerated breathing, mental cloudiness, confusion
Changes in vital signs (late signs) IIP - Ans -- increased temperature
- hypothalamus responsible for vital signs
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- HR decrease, swelling hypothalamus, lead to periods of apnea- Cheyne Stokes
,- BP go up in response to pulse decrease, widening pulse pressure * S is increased and D is
decreased, distance between them is increased
Headache IIP - Ans -- increase with intensity, aggravated by movement
Vomiting- IIP - Ans -- no nausea, just projectile, pressure on vagus nerve
Glascow Coma Scale IIP - Ans -- acute care setting, not rehab
- lowest is 3 and highest 15, 6 or 7 in trouble, semi coma
- eye 1-4, motor 1-6, verbal 1-5
Neuro Assessment IIP - Ans -- pupil reactivity, extremity movement and strength and
vital signs
- look for papilledema (swelling of optic nerve)
- PERRLA (pupils, equal, round, reactive to, light, accommodation (ability to focus on
objects close up and far away)
Cerebral Vascular Disease Definition - Ans -any functional abnormality of the CNS
caused by interruption of the normal blood supply to the brain. The most common cause of
CVD is arteriosclerosis of the internal carotid. CVD is the 3rd leading cause of death in the
USA. Remember that arteriosclerosis refers to a groups of diseases characterized by
thickening of walls and atherosclerosis is deposit of plaque
- CVD can cause a TIA and/or a CVA
Risk Factors for Cerebral Vascular Disease (13) - Ans -1. age (advanced)
2. HTN (stress)
3. Heart disease
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4. diabetes
, 5. increased cholesterol (diet)
6. TIA
7. coumadin (anticoagulants)
8. smoking
9. dysrythmias- clotting risk
10. obesity
11. all contraceptives, with other risk factors
12. drug use
13. family history
Ischemic (80% strokes) Definition and due to 3 reasons - Ans -- decreased blood flow
to brain tissue- infarcted areas will become edematous (due to inflammatory response at
the sight of infarct) If that infarcted areas are large enough, the cerebral edema may
increase to the point of displacing the brain and forcing it through foramen magnum
leading to death
1. thrombosis
2. embolism
3. decreased blood flow due to atherosclerotic changes of the arteries
Cerebral Thrombosis - Ans -- m>w, 30-50% will have history of TIAs. Represents the
most common cause of stroke for those >50
Cerebral Embolism - Ans -- clot from another site travels to the brain. M>W
Hemorrhagic CVA (20%) - Ans -- trauma to the head, tissue edema
- neurons are damaged at the site of hemorrhage, increased ICP develops due to tissue
edema from the injury and from the space occupying blood that has spilled into the area
3
Page
and displaced the brain which can lead to a shift of the brain
dilantin - Ans -an anticonvulsant drug (trade name Dilantin) used to treat epilepsy
and that is not a sedative
Increased Intracranial Pressure (IICP) Definition - Ans -- refers to the pressure of the
subarachnoidal fluid that is present in the space between the skull and the brain. Any
disruption of cerebral circulation can lead to IICP. The major complication of IICP is brain
stem herniation. Normal ICP is 0-15 mm/hg. Mild increase is 16-20, a moderate increase is
21-30, a severe increase is 31-40 and any reading above 40 is considered a very severe
increase
Assessment of IIP (7) - Ans -1. level of responsiveness
2. change in behavior (early signs)
3. changes in vital signs (late signs)
4. headache
5.vomiting
6. Glascow Coma scale
7. Neuro Assessment
Level of responsiveness IIP - Ans -AKA level of wakefulness, comatosed
Changes in behavior IIP (early signs) - Ans -AKA mental acuity
- terms to describe: restlessness, exaggerated breathing, mental cloudiness, confusion
Changes in vital signs (late signs) IIP - Ans -- increased temperature
- hypothalamus responsible for vital signs
1
Page
- HR decrease, swelling hypothalamus, lead to periods of apnea- Cheyne Stokes
,- BP go up in response to pulse decrease, widening pulse pressure * S is increased and D is
decreased, distance between them is increased
Headache IIP - Ans -- increase with intensity, aggravated by movement
Vomiting- IIP - Ans -- no nausea, just projectile, pressure on vagus nerve
Glascow Coma Scale IIP - Ans -- acute care setting, not rehab
- lowest is 3 and highest 15, 6 or 7 in trouble, semi coma
- eye 1-4, motor 1-6, verbal 1-5
Neuro Assessment IIP - Ans -- pupil reactivity, extremity movement and strength and
vital signs
- look for papilledema (swelling of optic nerve)
- PERRLA (pupils, equal, round, reactive to, light, accommodation (ability to focus on
objects close up and far away)
Cerebral Vascular Disease Definition - Ans -any functional abnormality of the CNS
caused by interruption of the normal blood supply to the brain. The most common cause of
CVD is arteriosclerosis of the internal carotid. CVD is the 3rd leading cause of death in the
USA. Remember that arteriosclerosis refers to a groups of diseases characterized by
thickening of walls and atherosclerosis is deposit of plaque
- CVD can cause a TIA and/or a CVA
Risk Factors for Cerebral Vascular Disease (13) - Ans -1. age (advanced)
2. HTN (stress)
3. Heart disease
2
Page
4. diabetes
, 5. increased cholesterol (diet)
6. TIA
7. coumadin (anticoagulants)
8. smoking
9. dysrythmias- clotting risk
10. obesity
11. all contraceptives, with other risk factors
12. drug use
13. family history
Ischemic (80% strokes) Definition and due to 3 reasons - Ans -- decreased blood flow
to brain tissue- infarcted areas will become edematous (due to inflammatory response at
the sight of infarct) If that infarcted areas are large enough, the cerebral edema may
increase to the point of displacing the brain and forcing it through foramen magnum
leading to death
1. thrombosis
2. embolism
3. decreased blood flow due to atherosclerotic changes of the arteries
Cerebral Thrombosis - Ans -- m>w, 30-50% will have history of TIAs. Represents the
most common cause of stroke for those >50
Cerebral Embolism - Ans -- clot from another site travels to the brain. M>W
Hemorrhagic CVA (20%) - Ans -- trauma to the head, tissue edema
- neurons are damaged at the site of hemorrhage, increased ICP develops due to tissue
edema from the injury and from the space occupying blood that has spilled into the area
3
Page
and displaced the brain which can lead to a shift of the brain
