Page 4 of 2 Practicum I: Adult Health - Adults & Gerontology ©2016 South University
Neurological Conditions Week 9 Perform a general examination, focusing on the neurological aspect as well as the site of recent infection, surgery, or trauma. Order a complete blood count (CBC) and an erythrocyte sedimentation rate (ESR), a C-reactive protein test, and blood culture. The CBC and blood culture may be negative initially. An MRI with and without contrast is the test of choice for localization of the lesions. Treatment This is a medical emergency that requires an immediate referral to the nearest emergency department for intervention. Other Causes of Headaches Subdural Hematoma Signs and Symptoms An acute subdural hematoma is a result of trauma and may present as a headache with possible loss of consciousness. A chronic subdural hematoma may be present for an extended period in an elderly patient before he or she notes any pain. The headache from a subdural hematoma is dull and aching and may be transient at first. The pain worsens over days to weeks. In children, especially those involved in contact sports, subdural hematomas are typically a result of head trauma. Evaluation Review the patient's history carefully. Note any recent trauma, keeping in mind that the patient may have experienced the trauma days or weeks prior to the onset of symptoms. In the elderly population, an altered mental status is a late sign but often occurs before pain does. If allowed to progress, the neurological status will deteriorate to the point of a coma. A CT scan of the brain is the diagnostic test of choice in the acute care setting and will provide information on acute and chronic subdural hematomas. An MRI of the brain with and without contrast will show any other abnormalities. Treatment Refer the patient to neurosurgery for further evaluation and treatment. Subarachnoid Hemorrhage Signs and Symptoms The patient presents with an acute headache, often stating, "This is the worst headache of my life!" A subarachnoid hemorrhage (SAH), or a stroke, is a medical emergency that requires an immediate referral and intervention. Evaluation The most common age group to experience an SAH is the fifty- to sixty-year-old population. The headache is worse when lying down and better when sitting up (because of relief of intracranial pressure). Nausea, vomiting, and rapid deterioration of the neurological status are noted. A noncontrast CT scan is the test of choice in this scenario. Treatment The patient requires immediate transfer to the nearest emergency department for rapid intervention. Page 5 of 2 Practicum I: Adult Health - Adults & Gerontology ©2016 South University
Neurological Conditions Week 9 Cranial Lesions Tumor Signs and Symptoms Brain tumors are either malignant or benign. A primary, malignant brain tumor is rare in the US population (0.65% of all cancers in men and 0.5% of all cancers in women, accounting for only 2% of all cancers). Headaches do not occur until the lesions are large enough to increase intracranial pressure. The
You've reached the end of your free preview.
Want to read all 18 pages?
- Summer '17