Podcast
Questions and Answers
What physiologic change is most likely to lead to an increase in intracranial pressure?
What physiologic change is most likely to lead to an increase in intracranial pressure?
- Hypernatremia
- Cerebral vasodilation (correct)
- Respiratory hyperventilation
- REM sleep
What is the primary cause of manifestations of acute brain ischemia (Cushing reflex)?
What is the primary cause of manifestations of acute brain ischemia (Cushing reflex)?
- Autoregulation of body systems
- Parasympathetic nervous system activation
- Loss of brainstem reflexes
- Sympathetic nervous system activation (correct)
What triggers vasodilation, increased capillary pressure, and increased edema in the brain?
What triggers vasodilation, increased capillary pressure, and increased edema in the brain?
- Cerebral hypoxia (correct)
- Adequate blood perfusion
- Decreased capillary pressure
- Cerebral vasoconstriction
What is the effect of an extreme increase in intracranial pressure on the sympathetic nervous system?
What is the effect of an extreme increase in intracranial pressure on the sympathetic nervous system?
What is the term for the intense reaction by the sympathetic nervous system to an extreme increase in intracranial pressure?
What is the term for the intense reaction by the sympathetic nervous system to an extreme increase in intracranial pressure?
What is the result of compression of vessels in the brain due to fluid collection?
What is the result of compression of vessels in the brain due to fluid collection?
What is the primary cause of increased edema in the brain?
What is the primary cause of increased edema in the brain?
What is the term for the process whereby fluid collection in the brain leads to compression of vessels?
What is the term for the process whereby fluid collection in the brain leads to compression of vessels?
What is the effect of an extreme increase in intracranial pressure on cerebral perfusion?
What is the effect of an extreme increase in intracranial pressure on cerebral perfusion?
What is the term for the process initiated by fluid collection in the brain leading to compression of vessels, triggering a series of physiologic changes?
What is the term for the process initiated by fluid collection in the brain leading to compression of vessels, triggering a series of physiologic changes?
What is the most frequent cause of cerebral aneurysm?
What is the most frequent cause of cerebral aneurysm?
What is commonly associated with leakage of cerebrospinal fluid from the nose or ears?
What is commonly associated with leakage of cerebrospinal fluid from the nose or ears?
What symptom is typically reported by a patient before the rupture of a cerebral aneurysm?
What symptom is typically reported by a patient before the rupture of a cerebral aneurysm?
Why is volume expansion and blood pressure support necessary in managing subarachnoid hemorrhage?
Why is volume expansion and blood pressure support necessary in managing subarachnoid hemorrhage?
What is the typical focus of treatment in the acute phase of stroke?
What is the typical focus of treatment in the acute phase of stroke?
What is not a typical consideration in the acute phase of stroke?
What is not a typical consideration in the acute phase of stroke?
What is the usual cause of embolic stroke?
What is the usual cause of embolic stroke?
What is the most common cause of subdural hematomas?
What is the most common cause of subdural hematomas?
What is the cause of meningitis?
What is the cause of meningitis?
What is a symptom not associated with rupture of a cerebral aneurysm?
What is a symptom not associated with rupture of a cerebral aneurysm?
Which statement about Cushing reflex is correct?
Which statement about Cushing reflex is correct?
What does decorticate posturing indicate?
What does decorticate posturing indicate?
What can result from acceleration-deceleration movements of the head?
What can result from acceleration-deceleration movements of the head?
What is the cause of secondary injury after head trauma?
What is the cause of secondary injury after head trauma?
What is an inappropriate treatment for head trauma?
What is an inappropriate treatment for head trauma?
What is a risk factor for hemorrhagic stroke?
What is a risk factor for hemorrhagic stroke?
Which type of stroke has the highest morbidity and mortality among stroke etiologies?
Which type of stroke has the highest morbidity and mortality among stroke etiologies?
What are the clinical manifestations of a stroke in the right cerebral hemisphere?
What are the clinical manifestations of a stroke in the right cerebral hemisphere?
What is the most important preventive measure for hemorrhagic stroke?
What is the most important preventive measure for hemorrhagic stroke?
What is the focus of treatment in the acute phase of stroke?
What is the focus of treatment in the acute phase of stroke?
Which of the following is a common complication that must be monitored and managed in patients experiencing subarachnoid hemorrhage?
Which of the following is a common complication that must be monitored and managed in patients experiencing subarachnoid hemorrhage?
What combination of symptoms is most consistent with meningitis?
What combination of symptoms is most consistent with meningitis?
How is vasospasm managed in patients experiencing subarachnoid hemorrhage?
How is vasospasm managed in patients experiencing subarachnoid hemorrhage?
Which condition is characterized by fever, headache, and confusion that evolve over several days?
Which condition is characterized by fever, headache, and confusion that evolve over several days?
What is the primary cause of manifestations of acute brain ischemia (Cushing reflex)?
What is the primary cause of manifestations of acute brain ischemia (Cushing reflex)?
What is the usual cause of embolic stroke?
What is the usual cause of embolic stroke?
What is the most frequent cause of cerebral aneurysm?
What is the most frequent cause of cerebral aneurysm?
What can result from acceleration-deceleration movements of the head?
What can result from acceleration-deceleration movements of the head?
What is the term for the process initiated by fluid collection in the brain leading to compression of vessels, triggering a series of physiologic changes?
What is the term for the process initiated by fluid collection in the brain leading to compression of vessels, triggering a series of physiologic changes?
What is the effect of an extreme increase in intracranial pressure on cerebral perfusion?
What is the effect of an extreme increase in intracranial pressure on cerebral perfusion?
What GCS level is considered to be normal?
What GCS level is considered to be normal?
What occurs when a brainstem-impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes?
What occurs when a brainstem-impaired patient exhibits a persistent rhythmic or jerky movement in one or both eyes?
Which condition is characterized by eyes not moving together in the same direction?
Which condition is characterized by eyes not moving together in the same direction?
What is the primary cause of acute brain injury?
What is the primary cause of acute brain injury?
Which condition is a cause of acute brain injury?
Which condition is a cause of acute brain injury?
Which condition progresses rapidly and is an acute cause of brain injury?
Which condition progresses rapidly and is an acute cause of brain injury?
What is the doll’s-eyes test used to assess?
What is the doll’s-eyes test used to assess?
Which cranial nerve dysfunction results in impaired eye muscle movements in one or more directions?
Which cranial nerve dysfunction results in impaired eye muscle movements in one or more directions?
What is the term for the condition where the eyes turn in a direction opposite to the direction of head rotation?
What is the term for the condition where the eyes turn in a direction opposite to the direction of head rotation?
Which condition is characterized by persistent rhythmic or jerky movement in one or both eyes?
Which condition is characterized by persistent rhythmic or jerky movement in one or both eyes?
What is the usual cause of encephalitis?
What is the usual cause of encephalitis?
Where is epidural bleeding located?
Where is epidural bleeding located?
What is the most important determinant for prescribing therapy for acute stroke?
What is the most important determinant for prescribing therapy for acute stroke?
What is the normal range of intracranial pressure?
What is the normal range of intracranial pressure?
When does cytotoxic edema occur?
When does cytotoxic edema occur?
What is a severe complication of elevated intracranial pressure?
What is a severe complication of elevated intracranial pressure?
What is the purpose of the Glasgow Coma Scale (GCS)?
What is the purpose of the Glasgow Coma Scale (GCS)?
What is the significance of a sluggish pupil response to light?
What is the significance of a sluggish pupil response to light?
What does a Glasgow Coma Scale (GCS) level of 3 indicate?
What does a Glasgow Coma Scale (GCS) level of 3 indicate?
What does a GCS level of 8 indicate?
What does a GCS level of 8 indicate?
Study Notes
Pathophysiology of Head Trauma and Stroke
- Cushing reflex is a last attempt by the brain to restore cerebral perfusion, not indicative of loss of brainstem reflexes
- Decorticate posturing indicates poor neurologic functioning
- Acceleration-deceleration movements of the head can result in polar injuries in two opposite poles of the brain
- Secondary injury after head trauma is a result of the body's response to tissue damage
- Inappropriate treatment for head trauma includes hypoventilation
- Risk factors for hemorrhagic stroke include acute hypertension
- Intracerebral hemorrhage has the highest morbidity and mortality among stroke etiologies
- Clinical manifestations of a stroke in the right cerebral hemisphere include left-sided muscle weakness and neglect
- Blood pressure control is the most important preventive measure for hemorrhagic stroke
- In the acute phase of stroke, treatment focuses on stabilization of respiratory and cardiovascular function
- Intracerebral hemorrhage carries a 38% mortality rate, with death usually occurring within minutes to hours
- Aphasia is an integrative language disorder that occurs with brain damage to the dominant cerebral hemisphere
Neurological Disorders and Pathophysiology Key Points
- Encephalitis is usually caused by viral infection in brain cells, and it accounts for the majority of encephalitis cases.
- Death occurs in 5% to 20% of encephalitis cases.
- Epidural bleeding is located between the arachnoid and the dura mater, and it is characterized by a lucid interval immediately after injury.
- The most important determinant for prescribing therapy for acute stroke is whether it is ischemic or hemorrhagic in cause.
- Intracranial pressure normally ranges from 0 to 15 mm Hg.
- Cytotoxic edema occurs when ischemic tissue swells due to cellular energy failure.
- A severe complication of elevated intracranial pressure is brain herniation, which is associated with rapid neurologic demise unless corrected quickly.
- The Glasgow Coma Scale (GCS) is used to assess the level of consciousness in acutely brain-injured patients.
- The first indication of brain compression from increasing intracranial pressure may be a sluggish pupil response to light.
- On the Glasgow Coma Scale, the lowest total score of 3 indicates likely fatal damage.
- A GCS level of 8 indicates severe damage, and a level of 12 or higher indicates mild damage.
- A GCS level of 3 indicates likely fatal damage, especially if both pupils fail to respond to light and oculovestibular responses are absent.
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Description
Test your knowledge of the pathophysiology of head trauma and stroke with this quiz. Explore concepts such as Cushing reflex, posturing, polar injuries, secondary injury, hemorrhagic stroke risk factors, clinical manifestations, and preventive measures.
