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Hematoma cerebral vasospasm infection ischemia

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hematoma, cerebral vasospasm, infection, ischemia related to systemic factors Trauma caused to brain tissue -Causes loss of function in part of the body controlled by the area of the brain -Cell damage and bleeding lead to inflammation and vasospasm around the injury site Increased ICP, generalized ischemia, and dysfunctions
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Some recovery may occur such as scar tissue formation Hematomas: classified by their locations in relation to the meninges Epidural hematoma : results from bleeding between the dura and the skull and sings usually arise within few hours of the injury Subdural hematoma: Develops between the dura and arachnoid Hematoma may be acute or Subacute Tear in the arachnoid space may allow CSF to leak into the subdural space leading to additional pressure (pressure comes from hemolysis increasing the osmotic pressure) All types of hematomas lead to local pressure on adjacent tissue and a general increase in ICP Etiology: In young adults: sports injuries, car or motorcycle accidents, and falls in any age group are a common cause of head injuries Signs & symptoms Focal signs and generalized signs of increased ICP Seizures (often focal but may be generalized) Cranial nerve impairment may occur Otorrhea or rhinorrhea (due to leaking of CSF from ear or nose) Fever: may be a sign of hypothalamic impairment, cranial infection, or systemic infection Treatment: CT & MRI scans (useful in determining the extent of the brain injury), glucocorticoids agents (decrease edema), antibiotics (reduce the risk of infection), surgery may be necessary (to reduce the ICP) and blood products and oxygen (to protect the remaining brain tissue) Increased intercranial pressure Brain is encased in rigid, nonexpendable skull Fluids, blood, CSF are not compressible Increase in fluid or additional mass causes increased pressure in the brain Ischemia and eventual infarction of the brain tissue ICP continues to rise and so does the blood pressure increased pulse pressure is significant in people with ICP Pressure on occulomotor nerve (CN III) affects the size and response to the pupils Pupil ipsilateral to lesion because fixed & dilated As pressure increases shift of contents across the midline both pupils become fixed and dilated Ptosis (droopy eyelid0 may occurs due to the pressure on CN III Increased intercranial pressure is common in many neurological problems such as brain hemorrhage, trauma, cerebral edema, infection, tumors, and abnormal circulation of CSF Cerebral perfusion pressure Normal 5 to 15 mm HG Cause in increased in intracranial content: tumor growth, edema, excessive CSF or hemorrhage Early signs of increased ICP: decreasing level or consciousness or decreased responsiveness, decreased papillary response, severe headache from stretching of dura and blood vessel walls, projectile vomiting not associated with food intake from stimulation of emetic center in the medulla, and papillledema from optic disc swelling
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