Chapter 18: Neurologic Emergencies

brainstem

controls breathing, BP, swallowing, and pupil constriction

cerebellum

controls muscle and body coordination

cerebrum

controls emotion/thought (front), sensation/movement (middle), and sight (back)

foramen magnum

hole in skull that allows for nerves to join in spinal cord and exit from brain

tension headache

caused by muscle contractions in head and neck, attributed to stress, described as squeezing, dull, or as an ache (no treatment required)

migraine headache

unilateral, caused by changes in blood vessel size in base of brain, described as pounding, throbbing, or pulsating, nausea/vomiting/photophobia, last a while

sinus headache

caused by pressure from accumulated fluid in sinuses, may have cold like symptoms (no treatment needed)

cerebrovascular accident (CVA, aka stroke)

interruption of blood flow to an area within the brain that results in loss of brain function

ischemia

reduced/restricted blood flow to a specific part of the body

ischemic stroke

stroke that occurs when blood flow to specific part of brain is stopped by a blockage/blood clot, thrombosis or embolus

hemorrhagic stroke

stroke that occurs when a blood vessel ruptures and accumulated blood forms a blood clot that compresses brain tissue, often massive and fatal

aneurysm

sweeling/enlargement of the wall of an artery resulting from defect or weakening of arterial wall

berry aneurysm

hemorrhagic stroke that occurs in an otherwise healthy young person by a weakness in a blood vessel, “worst headache of my life”, subarachnoid hemorrhage

transient ischemic attack

aka mini strokes, strokelike symptoms that resolve on their own in less than 24 hours

aphasia

inability to produce or understand speech, caused by stroke affecting left cerebral hemisphere

neglect

stroke survivor loses consciousness of one side of their body without knowing, caused by stroke affecting right cerebral hemisphere

seizure

a neurologic episode caused by a surge of electrical activity in the brain

generalized (tonic-clonic) seizure

results from abnormal electrical discharges from large areas of the brain usually involving both hemispheres, unconsciousness and generalized severe twitching of all muscles that lasts several minutes or longer

absence seizure

doesn’t involve any changes in motor activity, brief lapse of consciousness in which patient seems to stare and not respond

focal-onset aware seizure

partial seizure with no change in patient’s LOC, common in children

focal-onset impaired-awareness seizure

partial seizure where patient has altered mental status and doesn’t interact normally with their environment, “day terrors”, lip smacking/eye blinking/isolated jerking

aura

warning sign before seizure, can include visual changes or hallucinations, doesn’t happen with everyone

postictal state

period after a seizure where patient regains consciousness, may appear dazed, confused, or fatigued

status epilepticus

seizures that continue every few minutes without person regaining consciousness or that last longer than 30 minutes

hemiparesis

weakness on one side of the body, resembles stroke but resolves

delirium

a symptom NOT disease, severe state of mental confusion/altered awareness, can be reversed with proper treatment