Week 5 - Neuro Notes .docx - Week 5 Neuro Pediatric Differences \u2022 Infant Brain \u2013 Develops rapidly until age 4 \u2013 Suture lines between skull bones

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?