Week 5 - Neuro Pediatric Differences • Infant Brain – Develops rapidly until age 4 – Suture lines between skull bones ossified by age 12 • Myelination – Coordination – Motor skills Altered States of Consciousness • Altered LOC = Neurologic Dysfunction – Assess Alertness and cognitive power – Glasgow Coma Scale Different criteria for infants and older children Decline in LOC follows a pattern of confusion, delirium, obtundedness, stupor, to coma Injury by Severity • Concussion or mild brain injury 13-15 GCS • Moderate brain injury 9-12 GCS Loss of consciousness • Severe Brain Injury 8 or less GCS Coma Increased ICP • Altered States of Consciousness (cont.) • Intracranial Pressure (ICP) • Increased ICP Can Cause Damage Early Signs Headache Visual disturbance Nausea/vomiting Pupils unequal or slow Lethargy Infants : increased head circumference, bulging fontanels • Intracranial Pressure (ICP) Late Signs • Significant LOC decrease, • Increased systolic BP and pulse pressure • Bradycardia • Irregular respirations
Week 5 - Neuro • Fixed, dilated pupils Cushing’s Triad • Increased Systolic • Decreased Diastolic • Bradycardia • Widening Pulse Pressure • Irregular Respirations Hydrocephalus- clinical manifestations • Newborns and infants – Bulging fontanels – Increased head circumference – Sun set eyes – Irritability – High-pitched, catlike cry – Visible scalp veins • Children – Headache – Visual disturbance – Nausea/vomiting – Pupils sluggish – Decrease in consciousness – Seizures – Cushing’s Triad Widening pulse pressure Bradycardia Irregular respirations Seizures • Most common neurologic dysfunction in kids – Caused by malfunctions of brain’s electrical system Infections or high fever Chemical imbalance of the body that causes loss of metabolism Congenital conditions or trauma Genetic factors and family history Brain tumors and neurological problems Habits of the mother like smoking, alcohol consumption, drugs and certain medications Types of Seizures • Absence – (3-12 years old)5-10 sec. Lip smacking, staring, twitching, brief loss of consciousness • Partial (focal)
Week 5 - Neuro – Less than 30 sec., one extremity • Generalized (tonic-clonic or grand mal) • Febrile Dependent • Epilepsy – Chronic disorder Febrile Seizures • Usually higher than 38.9 C or 101F • Usually short in duration. Instruct parents to call 911 if longer than 5 minutes • Use antipyretics and cooling measures Seizure Disorders • Partial or Generalized • Record – Time start and stop – Aura? Triggers?
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- Fall '18
- Intracranial pressure, Traumatic brain injury, Headaches, Hydrocephalus, Seizures