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Prognostication in Neuro Disasters

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Information about Prognostication in Neuro Disasters
Health & Medicine

Published on February 25, 2014

Author: oliflower

Source: slideshare.net

Description

Oli Flower discusses the tricky issue of prognostication in neuro disasters. This includes intracerrebral haemorrhage, traumatic brain injury, subarachnoid haemorrhage and ischaemic stroke. From Bedside Critical Care 2013 in Cairns. Go to Intensive Care Network for the audio and much more.
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PROGNOSTICATION! AFTER! NEURO! DISASTERS

ICH

size image by Geigy

age image by Bev Sykes

GCS photo by og2t // ou gee tew tee

LOCATION LOCATION LOCATION

ABOVE OR BELOW THE TENT photo by Michael Matti

DEMENTIA photo byKurt Komoda

func

84M! GCS 7! 80 ml ICH! Basal ganglia bleed! Some IVH! Mild cognitive impairment

72F! GCS 10! 20 ml ICH! Lobar bleed! No IVH! No cognitive impairment

TBI

GCS

GCS SHOCK

GCS SHOCK >60

GCS SHOCK >60

GCS SHOCK >60

GCS SHOCK >60

Australia! 37M! GCS 3! Pupils reacting! No hypoxia or hypotension! Isolated TBI! CT with petichial haemorhages, mass effect 3rd ventricle compressed, no SAH, no MLS! BGL 7.0 Hb 8.8

aSAH

35% photo by liquidnight

photo by Keoni Cabral DISABILITY CAN BE HARD TO MEASURE

GRADE! AGE BLOOD

GCS photo by og2t // ou gee tew tee

H H 1 Asymptomatic, mild headache, slight nuchal rigidity 2 Moderate to severe headache, nuchal rigidity, no neurologic deficit other than cranial nerve palsy 3 Drowsiness / confusion, mild focal neurologic deficit 4 Stupor, moderate-severe hemiparesis 5 Coma, decerebrate posturing

Grade GCS Motor deficit I 15 - II 13-14 - III 13-14 + IV 7-12 -/+ V 3-6 -/+

CARTER

So this means.....? photo by Leo Reynolds photo by Leo Reynolds

HCP SEIZURE SEIZURE DRUGS

THE! HISTORY

THE! ANEURYSM

AED

ANAEMIA HYPERGLYCAEMIA ICU COMPLICATIONS LOW VOL CENTRES

STROKE

16 6 42

LEVEL! OF! CONSCIOUSNESS

HORIZONTAL EYE MOVEMENT

VISUAL! FIELDS

FACIAL! PALSY

MOTOR:! ARMS

MOTOR:! LEGS

LIMB! ATAXIA

SENSORY

LANGUAGE & SPEECH

Inattention

The patient and family understand the potential risks and benefits of therapy

SPAN-100

ICH SCORE FUNC! TBI IMPACT CRASH! SAH WFNS! CVA NIHSS

BE! AN! INFORMED! AGNOSTIC.

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