KCCs Chapter 511 cards

Tagged as: geometry, psychology, music

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1

Types of headaches

1. vascular headache a. migraine b. cluster headache 2. tension headache

2

pseudotumor cerebri

Condition of unknown cause characterized by headache and elevated intracranial pressure with no mass lesion. e.g. papilledema (swelling of optic disc)

3

temporal arteritis

Treatable cause of headache that affects temporal arteries and other blood vessels supplying the eyes. Diagnosis is made by measuring blood erythrocyte sedimentation rate (ESR) and temporal artery biopsy.

4

intracranial mass lesion

Anything abnormal that occupies volume within the cranial vault. E.g. tumor, hemorrhage, abscess, edema, hydrocephalus, etc.

5

mass effect

Any distortion of normal brain geometry due to a mass lesion.

6

midline shift

Dramatic shift of brain structures away from the side of the lesion. (pineal calcification is useful landmark for extent of shift at level of upper brainstem)

7

intracranial pressure

Pressure within intracranial space formed by volume of CSF, blood, and brain tissue.

8

cerebral perfusion pressure

Mean arterial pressure minus intracranial pressure. CPP = MAP - ICP Decreases as intracranial pressure increases. Goal of therapy is to keep CPP above 50mm Hg.

9

Signs/symptoms of elevated intracranial pressure

- headache (worse in morning) - altered mental status - nausea/vomiting - papilledema - diplopia - Cushing's triad

10

Cushing's triad

1. hypertension (reflex mechanism to maintain cerebral perfusion pressure) 2. bradycardia (response to hypertension) 3. irregular respirations (due to impaired brainstem functions)

11

treatment for elevated intracranial pressure

(measures used to buy time while treating underlying cause) - elevate/straighten head to avoid jugular venous return obstruction - intravenous mannitol - ventricular drain - hemicraniectomy (removal of skull overlying mass lesion) - steroids (reduce cerebral edema)