What is raised intercranial pressure in the brain?
The pressure increased by fluids, such as cerebrospinal fluid (CSF) or blood, inside the skull and on the brain tissue
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What is normal intercranial pressure?
less than 15mmHg
(usually 7-15)
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What is cerebrospinal fluid?
(CSF)
a shock absorber
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What is the Monro-Kellie hypothesis?
States that 3 constituents of the cranium are incompressible, so an increase is one must be offset by a decrease in the other
(80% brain, 10% CSF, 10% blood)
After a head injury, suspected skull fracture, pr post-traumatic seizure, how soon should a patient have a CT head scan?
Within 1 hour
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What are the signs of a Basal skull fracture?
blood in ear cavity
'panda' eyes
cerebrospinal fluid leaking from ear/nose
Battle's sign - bruising at base of skull
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If you suspect a skull fracture, can you insert a nasopharyngeal airway?
NO
Can damage the skull and go through the intercranium
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What are the signs/symptoms of a stroke?
facial weakness/droop
loss of consciousness
visual disturbances
papilledema
loss of bladder control
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Describe FAST
F - face (facial droop, can they smile?)
A - arms (can they lift arms over head?)
S - speech (slurred speech, say ninety-nine)
T- time (call 999 or resus team)
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What are 2 types of stroke?
Ischaemic
Haemorrhagic
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What is the most common type of stroke?
Ischaemic
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On a CT scan, how can you tell between an ischaemic and haemorrhagic stroke?
Ischaemic - caused by blockage cutting off blood supply to the brain, eg: clot
Haemorrhagic - caused by bleeding in or around the brain
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What is the main treatment for ischaemic strokes?
IV alteplase (thrombolysis) or anti platelet treatment to break up clots
However, increases risk of haemorrhage
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What is the main treatment for haemorrhagic strokes?
Take routine bloods, coag screen and INR
Reversal of anticoagulation, eg: give blood products
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