ICP
ICP
Craniocerebral Injury
Cerebral Aneurysm and Subarachnoid Hemorrhage
Cerebral Aneurysm and Subarachnoid Hemorrhage
100
10-15 mm Hg
What is a normal intracranial pressure?
100
70-100
What is the normal range of cerebral perfusion pressure?
100
Acceleration, deceleration, rotation, shearing and penetrating
What are the different mechanisms of injury?
100
90% (most common)
What is a Berry or Saccular aneurysm?
100
localized dilation of arterial lumen caused by weakness of the vessel wall
What is an aneurysm?
200
skull-rigid, contents stable, constant relationship, decreased volume of any results in decreased volume of one or both
What is the Monro-Kellie hypothesis?
200
Intracentricular, subarachnoid bolt, epidural and fiberoptic
What are the different catheter types?
200
linear, comminuted, deperssed,basal skull fracture
What are the different skull fracture types?
200
4.5%-13% of all strokes
What is the prevalence of Cerebral Aneurysm and Subarachnoid Hemorrhage?
200
7 days
What is the peak for rebleeding post SAH?
300
95% of the brain's energy
What is aerobic glucose metabolism and production of ATP?
300
Hypertension with widened pulse pressure, bradycardia and abnormal respiratory patterns
What is Cushing's triad?
300
fracture through the base of the skull, anterior, middle or posterior fossa, high risk for complication of CNS infection
What is a basilar skull fracture?
300
85% of circulation and includes anterior cerebral artery, anterior communicating artery, posterior communicating artery
What is anterior circulation?
300
headache, fever, photophobia, lethargy, nausea, vomiting
What are the clinical signs after initial bleeding?
400
brain 2-3% body weight, receives 15% cardiac output, utilizes 20% oxygen, consumes 25% glucose
What is cerebral metabolism?
400
Ventricular drain/lumbar drain, ICP control, B/P management
What is the acute treatment of communicating hydrocephalus?
400
shearing of the axons, diagnosis: poor clinical status with relatively normal CT scan
What is diffuse axonal injury?
400
codeine 30-60 mg IM every four hours prn pain or morphine 2-4 mg every 3-6 hours
What is a sedative prescribed for SAH?
400
age (50's,60's, 70's), connective tissue disorder (polycystic kidney disease, Ehlers-Danlos syndrome), family history
What are some nonmodifiable risk factors for aneurysm?
500
Affects white matter, increased capillary permeability (break down of blood-brain barrier), most common, occurs with tumors, trauma and clots
What is a vasogenic cerebral edema?
500
Changes in LOC, worsening headaches, cognitive deficits, irregular respiratory patterns, bradycardia, seizure, aphasia and pupillary changes
What are some indicators of increased intracranial pressure?
500
arterial bleed, rapid onset of symptoms, risk of herniation, symptoms (LOC, dilated, nonreactive ipsilateral pupil)
What is Epidural Hematoma?
500
admit to to Neuro Intensive Care Unit, arterial line placement, intubate as needed, pumonary artery catheter placed, cardiac monitor, intracentricular catheter placed for developing hydrocephalus
What is the initial plan of care for a subarachnoid hemorrhage?
500
vital signs every hour (if stable), bed rest and HOB elevated 30 degrees, strict intake and output, thigh-high hose and pneumatic compression boots
What are the initial nursing orders for a subarachnoid hemorrhage?
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