Central Nervous System | Neurological Emergencies

Central Nervous System (CNS): brain and spinal cord, involved in the serious neurological problems.

Cognitive Systems: responsible for alertness, awareness, normal wakeful state
Cerebral Homeostasis: balance, maintaining brain perfusion and oxygenation using cerebral auto regulation.
Motor Control: affects tics to seizures, weakness to paralysis
Sensation: alterations in sensory systems accompany weakness>paralysis


Types of CNS Disorders: V I N D I C A T E

Vascular: involving circulation problems to the brain and spinal cord
Infections of the Brain, Spinal Cord and Meninges
Meningitis: viral is more common, milder, can’t treat. Bacterial is less common, more severe and can be treated with antibiotics
Encephalitis: infection of the brain tissue, usually viral
Brain Abscess: localized collection of pus and debris in the brain. One kind is from bacterial endocarditis – heart valve infection
Neoplastic: tumor metastasizing to the brain. Brain tumor is responsible for 1 outof 5 new-onset seizures in people over 21.
Degenerative: progressive deterioration of the CNS
Multiple Sclerosis
Inflammatory – types of inflammation without infection
Rheumatoid arthritis
Systemic lupus erythematosus
Congenital: rupture of a congenital aneurysm is the most common cause ofspontaneous intracerebral hemorrhage in a young person
Allergic and autoimmune: lupus cerebritus is an autoimmune inflammatorycondition. Severe allergic reactions can cause cerebral hypoperfusion and braindamage
Trauma: head trauma can obviously cause neurological problems
Endocrine and metabolic: glandular, electrolyte, hormonal imbalances may resultin neurological symptoms. Hypoglycemia and hypoxia and common and easily cared for.

General Appearance: first impression of how sick they appear
Level of consciousness: give them a challenging task, memorization
Speech: determine if there has been any recent changes
Skin: splotchy, bruised looking rash could be sign of meningitis
Posture and Gait: determine if there has been any recent changes
Vital signs:
Head and neck: Ketones on breath can smell like alcohol
Thorax and lungs: look for hypoventilation, CO2 retention and hypoxia
Cardiovascular: ECG changes can mimic AMI
Nervous system: look for symmetry. Marked differences in the two sides of the body are probably abnormal

Management: Ongoing assessment. ABCs. Assess blood glucose level, treat hypoglycemia. What is normal blood sugar again? 70-100? Start an IV with normal saline or LR

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