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PEDS final Neuro

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compression fractures of vertebre with falls
Because children have incomplete ossification of vertibral bodies, they are more prone to
bilateral fixed and dilated pupils
pupil change in ICP that indicates brainstem herniation from incrased intracranial pressure
tension
dull achy band around the head, intermittant, no vomiting, may last for days, not aggravated by physical activity
Noncommunicating hyrocephalus
blockage of CSF in VENTRICULAR SYSTEM prevents the CHF from entering arachnoid space
delirium
characterized by confusion, fear, agitation, hyperactivity or anxiety
communicating hydrocephalus
blockage of CSF in SUBARACHOIDNOID SPACE
rapid head growth
predominant manifestations of hyrocephalus in infants
inflammatory
frontal pain and tenderness over affected sinus, fever with activity
unilateral dilated and reactive pupil
pupil change in ICP associated with intracranial mass
fractures
Because children have thin cranial bones and unfused sutures, they are more prone to
consciousness
responsiveness of the mind to sensory stimuli
microcephaly
head size less than 3 cm s.d. below the mean for age and sex, associated with mental retardation
increased intracranial pressure
force exerted by brain tissue, cerebrospinal fluid, and blood within the cranial vault
transillumination
reveals a fluid filled skull, used to observe hydrocephalus
under 1 year of age
what age group is at greatest risk for bacterial meningitis
hemorrhage
Because children's brains are highly vascular, they have a small subarachnoid space they are more prone to
confusion
disoriented to time, place and peson in that order, may seem alert, inaccurate responses to complex questions
Glasgow Coma Scale
scale used to assess level of consciousness by assessing eye opening, verbal and motor response
dopamine or dobutamine
in order to maintain cerebral perfusion pressure in clinical therapy for ICP, you give what meds?
stupor
response to vigorous stimulation only (sternal rub for example), returns to the unresponsive state when stimulus removed
high spine injury (C1-C2)
Because children's spines are excessively mobile and they have immature ligaments, they are more prone to
assess for periteonitis
what to assess for in children with shunt in place for hydrocephalus
encephilitis
Kernig's and Brudzinski sign will probably NOT be positive with ___________
cognitive power
ability to process data and respond either verbally or physically
unconsciousness
depressed cerebral function, inability of the brain to respond to stimuli
alertness
ability to react to stimuli
migraine
aura, photophobia, n/v, increased pain with activity
early signs of ICP in all children
HA, double vision, N/V, dizziness, vertigo, slight change in VS, pupils not as reactive or equal, sunsetting eyes, seizures, slight change in LOC
increased ICP
predominant manifestations of hydrocephalus in older children
coma
severly diminished response and cannot be aroused even by painful stimuli
inflammatory
hot or cold applications, antibiotics, analgesics, antiyretics may be used to relieve this type of headache
migraine medications
ergot, isometheptene, supratriptan
fixed and dilated pupil
pupil change in ICP that is sign of impending brainstem herniation
Cushings Triad
Increased systolic BP, widened pulse pressure; bradycardia; irregular respirations- this is a late sign of ICP
tension relief
icepacks may be used to relieve these
early signs of ICP in infants
bulging fontenel, wide sutures, increased head circ., dilated scalp veins, high pitched cat like cry
bacterial meninigits
Kernig's and Brudzinksi sign will probably be POSITIVE with _________________ ______________
obtunded
limited response to the environment, falls asleep unless given verbal or tactile stimulation
falls
Because children are top heavy, they are more prone to
fever
bacterial meningitis in young infant will present with ________
afebrile, nuchal rigidity, SEVERE headache,positive kernig sign
clinical manifestations of bacterial meningitis in older children

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