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KCCs Chapter 511 cards
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1. vascular headache a. migraine b. cluster headache 2. tension headache
Condition of unknown cause characterized by headache and elevated intracranial pressure with no mass lesion. e.g. papilledema (swelling of optic disc)
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.
Anything abnormal that occupies volume within the cranial vault. E.g. tumor, hemorrhage, abscess, edema, hydrocephalus, etc.
Any distortion of normal brain geometry due to a mass lesion.
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)
Pressure within intracranial space formed by volume of CSF, blood, and brain tissue.
Mean arterial pressure minus intracranial pressure. CPP = MAP - ICP Decreases as intracranial pressure increases. Goal of therapy is to keep CPP above 50mm Hg.
- headache (worse in morning) - altered mental status - nausea/vomiting - papilledema - diplopia - 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)
(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)
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