Cerebral Edema
What are the tree types of cerebral edema?
Vasogenic, cytotoxic, and interstitial
What type of posturing is seen with increased ICP?
Decerebrate
What is a scalp laceration and what is it known for?
An external head trauma known for profuse bleeding
What is the difference between primary and secondary brain injuries?
Primary occurs at the initial injury and secondary occurs hours to days after the initial injury
What type of head trauma includes brain tissue tearing and is a penetrating injury?
Laceration
What cerebral infection can lead to cerebral edema?
Meningitis
What are the ocular signs of increased ICP?
Dilation (ipsilateral), sluggish, EOM (CN 3, 4, 6), fixed/dilated pupil, vision disturbances
What are the 2 locations of skull fracture bruising that appear 12-24 hours after injury?
Battle's sign (behind the ear) and raccoon eyes
What are the signs of a concussion?
Amnesia, decreased LOC, and amnesia
What type of contusion has these symptoms: blindness, visual hallucinations, decreased peripheral vision, poor visual recognition/attention, and word blindness
Occipital lobe contusion
Which type of cerebral edema has a disruption of the blood/brain barrier?
Vasogenic
What is Cushing's Triad?
High SBP (wide pulse pressure), irregular respirations, and bradycardia
What type of skull fracture is rare and requires a higher level of force to occur?
Basilar
What kind of edema is seen with a diffuse axonal injury?
Global edema
What are the symptoms of an epidural hematoma?
Brief unconsciousness, brief lucid interval, followed by decreased LOC
What are the causes of cytotoxic cerebral edema?
Destructive lesion, trauma, and SIADH
What are the complications of ICP? (3)
Decreased CBF, cerebral herniation, and brain death
What type of bleeding is seen with skull fractures?
Hemotympanum (behind the ear drum), hematoma, and sinuses
What are 4 ways to get cognitive rest after a concussion?
Decreases TV/videos, reading/schoolwork, attention, and concentration
What type of hematoma is between the dura mater and arachnoid layer and has 3 types (acute, subacute, and chronic)?
Subdural hematoma
What are the causes of interstitial edema?
Excess CSF production, obstruction of flow of CSF, the inability to reabsorb CSF, and hydrocephalus
What does the nurse do before, during, and after the placement of a ventriculostomy catheter?
Before: Obtain consent, put HOB 30 degrees, keep head midline/immobilized
During: Monitor vital signs every 5-15 minutes
After: Monitor drain/ICP, focused neurological exam, make sure a warning sign is over the HOB
What cannot be done if a patient has a basilar skull fracture?
No NGT/nasal intubation
What brain injury has symptoms including impulse control problems, aggression, mood swings, depression, paranoia, and anxiety
Chronic Traumatic Encephalopathy
What type of hematoma is within the brain tissue and is caused by hypertension, arteriovenous malformation, and aneurysms?
Intracerebral hematoma