* level of symptom is relevant to degree of injury eg. amnesia of event vs preceding to the event
72
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concussion TX
low stimulation, slow return to normal ADL/ activities, prevent second impact, if symptoms are severe TX focuses on receiving cerebral edema and ICP (slow and steady)
post concussion syndrome (>3months)
73
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infection (CNS)
spread via blood stream or direct entry
eg. fracture, procedure/surgery, other infected sites (sinuses and otitis media)
74
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encephalitis
infection in Brian parenchyma
75
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Myelitis
infection in spinal cord
76
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encephalomyelitis
infection in brain and spinal cord
77
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meningitis
inflammation of Pia matter arachnoid, subarachnoid space (CSF space)
* spread throughout due to infected CSF and flow within CSF * purulent (bacterial) and lymphocytic (viral)
depends on tumour origin, stage, size and location depender
* surgery - excision of tumour * radiation - gamma knife * chemo eg. alkalizing agents (DNA damage) * temozomide (TMZ * s/e: quickly replication eukaryotic cells (hairless, GI upset, bone marrow suppression, low BC counts)
88
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TX overview
* preserve brain function * treat causse (eg. abs, cerebral stunting, tPA, hematoma evac) * treat high ICP/ cerebral edema (hypertonic, osmotic diuretics, drainage of CSF (temp.)) * maintain VS * preserve function
89
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seizures
spontaneous, abnormally synchronous electrical discharges from neurons in the cerebral cortex
90
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idiopathic seizures
genetic origin, cause unknown - epilepsy
eg. alteration in ion channel transport
91
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idiopathic seizures TX
long term anti-epileptic meds
92
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symptomatic seizures
due to a brain injury
* results in altered action potential/ neurotransmitter balance/ electrolyte balance
93
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symptomatic seizures TX
short-term anti-epileptic meds; treat underlying cause
94
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3 main classes of seizures
* focal: specific groups of neutrons in one hemisphere * generalized: both hemispheres involved (eg. absence seizures, tonic-clinic seizures) * unknown: neither categories (eg. febrile seizures)
95
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seizures S&S
specific to seizure type
* loss of consciousness - common * aura/ partial seizure (maybe) * some w automatisms - repeating behaviour * may be in two or one hemisphere * may progress to other seizures (focal→ generalized) * ‘evolving seizures’
96
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life threatening seizure symptoms
* tonic convulsions: constriction of muscles (airway) * loss of consciousness: impairs respiratory rate/ depth * convulsions cause falls/ flailing- prevention * stem of ANS cause sever VS changes * tachycardia, HTN, reflex hypotension, hyperventilation
97
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seizure Dx
Eeg
MRI
98
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seizure TX
benazodiazepiens
barbiturates
anti-convulsants
99
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status epilepticus
seizure can process to an unstoppable state→ life threatening (ER)