Chapter 18: Neurologic Emergencies

Key Topics Covered:

• Anatomy and physiology of the nervous system
• Common neurological disease processes
• Assessment and management of neurological emergencies

Stroke

• Significance:
  • 5th leading cause of death in the U.S.
  • Leading cause of adult disability
• Risk Factors:
  • Common in geriatric patients
  • Family history and race
• Types of Stroke:
  • Ischemic Stroke:
    • 87% of all strokes
    • Caused by thrombus or embolism
    • Often results from atherosclerosis
  • Hemorrhagic Stroke:
    • 13% of strokes
    • Bleeding inside the brain
    • High-risk factors include stress, exertion, high blood pressure
  • Transient Ischemic Attack (TIA):
    • Stroke-like symptoms resolve in <24 hours
    • Warning sign for potential stroke

Seizures

• Causes:
  • Recent head injury, brain tumors, metabolic issues, fever, genetics
• Types of Seizures:
  • Generalized Seizure (Tonic-Clonic):
    • Abnormal electrical discharges affect large brain areas
  • Absence Seizures:
    • Brief lapse of consciousness
  • Partial (Focal) Seizures:
    • Simple: No loss of consciousness, localized symptoms
    • Complex: Altered consciousness, may perform repetitive actions
  • Status Epilepticus:
    • Seizure lasting >30 minutes or multiple without recovery

Headaches

• Types:
  • Tension Headaches:
    • Muscle contractions, stress-related
  • Migraine Headaches:
    • Linked to changes in blood vessel size
  • Sinus Headaches:
    • Caused by sinus pressure
• Serious Conditions:
  • Hemorrhagic stroke, brain tumor, meningitis

Altered Mental Status

• Causes:
  • Intoxication, hypoxia, stroke, metabolic disturbances

Neurological Anatomy and Physiology

• Main Brain Parts:
  • Cerebrum:
    • Controls emotion, thought, movement, sensation
  • Cerebellum:
    • Coordinates muscle movements
  • Brain Stem:
    • Manages basic life functions

Assessment and Management

• Patient Assessment:
  • Scene assessment, primary assessment (ABCs), history taking, vital signs
• Stroke Assessment Tools:
  • BE FAST mnemonic: Balance, Eyes, Face, Arms, Speech, Time
  • Glasgow Coma Scale
• Emergency Care:
  • Maintain airway, support circulatory function
  • Rapid transport to appropriate facility
  • Specific treatments based on condition (e.g., clot busters for stroke)

Review Questions (Examples)

• Understanding key signs and symptoms for identifying types of strokes and seizures
• Application of assessment scales and emergency care protocols

This summarizes the key points from the lecture on Chapter 18: Neurologic Emergencies. Focus on understanding the anatomy, types of neurological conditions, their symptoms, and emergency response procedures to effectively prepare for handling neurologic emergencies.