dr. maha al-sedik. objectives: introduction. headache. stroke
TRANSCRIPT
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Neurological Emergencies-2
Dr. Maha Al-Sedik
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Objectives: Introduction.
Headache.
Stroke.
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Neurological pathophysiology
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Pathophysiology:
Many different disorders can cause brain
dysfunction.
Can affect the patient’s level of consciousness,
speech, and voluntary muscle control
The brain is sensitive to changes in oxygen,
glucose, and temperature.
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General rule:
If a problem is caused by the heart and lungs, the
entire brain is affected.
If the problem is in the brain, only part of the brain
is affected.
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Neu
rolo
gic
al Em
erg
en
cie
s Headache
Stroke
Coma
Status epileptics
seizure
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One of the most common complaints.
Can be a symptom of another condition or a neurologic
condition on its own.
Most headaches are harmless and do not require
emergency medical care.
Haedache
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If it is sudden and severe.
If more than one patient reports headache,
consider carbon monoxide poisoning.
If there is another complaint e.g. hemorrhage.
When do you consider headache as an emergency?
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headache
Tension headache
Migraine headache
Sinus headache
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Headache
Tension headaches, migraines, and sinus headaches
are the most common.
Tension headaches:
Are the most common.
Caused by muscle contractions in the head and
neck.
Pain is usually described as squeezing, dull, or as
an ache.
The jaw, shoulder and neck may be stiff.
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Migraine headache:
Thought to be caused by changes in the blood vessel
size in the base of the brain
Pain is usually described as pounding, throbbing, and
pulsating.
Often associated with visual changes, nausea and
vomiting.
Can last for several days.
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Sinus headaches
Caused by pressure that is the result of fluid
accumulation in the sinus cavities
Patients may also have cold like symptoms of nasal
congestion, cough, and fever.
Pre-hospital emergency care is not required.
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Neu
rolo
gic
al Em
erg
en
cie
s Headache
Stroke
Coma
Status epileptics
seizure
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Also called a cerebrovascular accident (CVA).
Interruption of blood flow to the brain.
Without oxygen , brain cells stop working, results in
the loss of brain function and start to die.
Once the brain cells die, not much can be done.
It may take several hours or more for the cell to die.
Stroke
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Stroke
Ischemic Hemorrhagic.
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Ischemic Stroke
Most common, accounting for more than 80% of
strokes.
Results from an embolism or thrombosis.
Symptoms may range from nothing at all to
complete paralysis.
Atherosclerosis in the blood vessels is often the
cause.
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Atherosclerosis:
Disorder in which calcium and cholesterol form a
plaque forms inside the walls of the blood vessels
and may obstruct blood flow.
Eventually, it causes complete occlusion of an artery.
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Hemorrhagic Stroke
Accounts for 10% to 20% of strokes.
Results from bleeding inside the brain.
People at highest risk are those who have very high
blood pressure.
Cerebral hemorrhages are often fatal.
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An aneurysm:
Is a swelling or enlargement of an artery due to
weakening of the arterial wall.
A symptom may be the sudden onset of a severe
headache it is mostly described as the worst
headache in my life.
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Transient Ischemic Attack (TIA):
Normal processes in the body destroy a blood clot in
the brain.
Blood flow is restored.
The patient regains use of the affected body part.
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When stroke symptoms go away on their own in less
than 24 hours, the event is called a TIA.
Every TIA is an emergency.
May be a warning sign of a larger stroke to come.
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