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Brain Function Disor

Disorders of Brain Function

QuestionAnswer
Mechanisms of Brain Injury Ischemia Trauma Tumors Degenerative processes Metabolic derangements Hemorrhage
Several common pathways Hypoxic & ischemic effects Excitatory amino acid injury Cerebral edema Increased intracranial pressure Herniation Hydrocephalus
Manifestations of Global Brain Injury alterations in sensory and motor function changes in level of consciousness (LOC)
The most frequent sign of brain dysfunction is altered LOC behavior changes
Consciousness Alertness with orientation to: Person Place Time Normal speech Voluntary movement Oculomotor activity Normal arousal Normal content of thought
Altered LOC Confused & disoriented Inability to arouse: Lethargic Obtunded Stuporous Comatose
Coma No vocalization No spontaneous eye movement No arousal to a stimulus Brain reflexes are intact Light coma Coma Deep coma
Causes for Altered Arousal Structural, Metabolic & Pycchogenic
Skeletal muscle responses purposeful: follows command refelxive: response to stimuli only, generalized motor movement:ticks twiching or the are not present
Abnormal Posturing (in response to stimulus) DECORTICATE "flexor" arms flex at elbows, hand internally rotate, plantar flexion of legs DECEREBRATE "extensor" pronatinon of arms
Alterations in Cerebral Fluid Volume VASOGENIC:disruption of blood brain barrier; plasma proteins in ECF space CYTOTOXIC:toxic elements cause failure of active transpost mechanisms ISCHEMIC:follows cerebral infarction INTERSTITIAL: movement of CSF from ventricles to extracell tissue
ICP rise in CSF caused by: increase in tissue vol, abcess, hemhorrage, obstruction, deficient absorption
Hydrocephalus Ab increase in CSF volume, communicating or noncommunicating/obstructive
evaluation&tx of Hydrocephalus CT scan or MRI, Shunt, surgery, diuretic therapy
Compound fractures of skull
Created by: skhaled
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