Term
| majority of TBI pts die or leave hospital |
|
Definition
|
|
Term
| majority of TBI pts recover, or are longterm disabled |
|
Definition
|
|
Term
| TBI is the leading cause of death in what age group |
|
Definition
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|
Term
|
Definition
concussion
fallas
shaken baby syndrome |
|
|
Term
| what are the two categories of primary injury for TBI |
|
Definition
contact forces
inertial forces |
|
|
Term
| what are hte contact forces of TBI-3 |
|
Definition
skull fracture
contusion
hematoma |
|
|
Term
| what is the other name for secondary injuries of TBI |
|
Definition
|
|
Term
| what are the categories of secondary injuries of TBI-4 |
|
Definition
neurochem release during ischemia
complex rxn in edema
tissue hypoxeia
elevated intracranial pressure |
|
|
Term
| which is worse- ischemic or hemorrhagic stroke |
|
Definition
|
|
Term
| what is the mortality for hemorrhagic strokes in 30 days? |
|
Definition
|
|
Term
| the 3 different primary pathophys of bleeding stroke |
|
Definition
rupture cerebral vessel
blood into parenchyma
hematoma compresses other tissue |
|
|
Term
| what are the secondary causes of bleeding stroke |
|
Definition
ischemia
cerebral edema
toxic effects of blood |
|
|
Term
| hemostatis in a bleeding stroke leads to- |
|
Definition
|
|
Term
| what are the 2 main lcoaitons for a brain bleed |
|
Definition
|
|
Term
| the _ the bleed is the higher risk of mortality |
|
Definition
|
|
Term
| look on slide 14 to see the depth of bleeds |
|
Definition
|
|
Term
| Does increasing the dose of statin cause a bleeding stroke? |
|
Definition
|
|
Term
| what do 50% of pts with brain bleed have? |
|
Definition
|
|
Term
| what 2 races have higher risk fo brain bleed |
|
Definition
|
|
Term
| what are risk factors for brain bleed-3 |
|
Definition
chronic HTN
elderly
low serum cholesterol
lots of ethanol injestion vs liver dis |
|
|
Term
| what are drugs that can induce brain bleed |
|
Definition
warfarin/anticoags
TPA
blood pressure meds that if stop get rebound HTN
sympathomiemetics (cocaine) |
|
|
Term
| after what age does risk for brain bleed increasE? |
|
Definition
|
|
Term
| how is highest risk for brain bleed for 55-74 |
|
Definition
|
|
Term
| for 75-84 yo who is at highest risk for brain bleed |
|
Definition
|
|
Term
| for ppl 85+ who is at highest risk for a bleeding stroke |
|
Definition
|
|
Term
| what does the hemorrhagic stroke have differently for presenation than ischemic?-2 |
|
Definition
can show on CT scan early
more symtpoms of increased ICP |
|
|
Term
| what are symtpoms of increased ICP-3 |
|
Definition
decreased LOC
headache
vomitting |
|
|
Term
| complications of hemorrhagic stroke-3 |
|
Definition
cerebral edema
cardiac instability (bradycardia, hgih BP)
hydrocephalus |
|
|
Term
|
Definition
| lose ability to lose the CSF in the 3/4 ventricles so it accumulates in the brain. called water on the brain |
|
|
Term
| what two conditions are know to cause more mortality with TBI? |
|
Definition
|
|
Term
|
Definition
SBP>90
O2 sat>90%
optimize ICP/CPP (cerebral perfusoin pressure) |
|
|
Term
| the overal goal for TBI is- |
|
Definition
| Max recovery or salvage of neurological function |
|
|
Term
for a brain injury patient what scale is used?
what is a severe score range?
what score cant a person have? |
|
Definition
Glasgow coma scale
3-8
zero (arent any zeros on the scale) |
|
|
Term
| what are the 3 components of the cranium |
|
Definition
brain
CSF
blood/blood vessels |
|
|
Term
| intracranial pressure is the volume of what 3 things combined? |
|
Definition
|
|
Term
| buffering system sfor intrcranial pressure cna accomadate up to? |
|
Definition
|
|
Term
once the buffering intracranial pressure systme is exceeded what occurs?
what pt population is this common in |
|
Definition
intracranial hypertension
TBI |
|
|
Term
| at what glasgow score is intracranial pressure monitoiring reccomedned? |
|
Definition
|
|
Term
| when putting in a monitor for ICP, do you need infection prophylaxis? |
|
Definition
|
|
Term
| which ICP monitor can also do draining? |
|
Definition
|
|
Term
whcih ICP monitor do you use for mild cases?
why? |
|
Definition
subarachnoid
-doenst go into brain tissue so less accurate |
|
|
Term
what is the pro (2) about intraparnechymal vs ventricloscope?
what is the con? |
|
Definition
accuracy, simpler
cant drain |
|
|
Term
| what is a complicaiton of ICP monitors? |
|
Definition
|
|
Term
| increased ICP cna decrease what? |
|
Definition
|
|
Term
| increased ICP may result in -4 |
|
Definition
iscehmia
bradycardia
hydrocephalus
herniation |
|
|
Term
| what is normal ICP range? |
|
Definition
|
|
Term
| at what mm Hg does ICP need treatment? |
|
Definition
|
|
Term
| how do you calculate CPP? |
|
Definition
MAP - ICP
*remember this CCP is more important for treatment than those other two! |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Is ICP monitoring superior to clincical /imaging monitoring? |
|
Definition
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