Neuro Questions

[BeachGirl08]

Hi. Newbie here with a final coming up. I had a couple of questions about things that I can not narrow down on my own with books, notes etc. If anyone can point me in the right direction, I would be very appreciative.

Here goes.....

1. Difference b/t diffuse axonal injury and a brain stem injury. S/sx: LOC, now comatose, decerebrate posture, non-reactive pupils, abnormal respirations.

I can't find anything that discusses the difference b/t pupils in the two injuries. I am leaning towards the diffuse axonal, but still have questions.

2. Difference b/t subacute subdural hematoma and a epidural hematoma. S/sx: Fall on rt side of head, initial LOC, regained it, began to get sleepy. Rt pupil dilated. Muscle weakness.

I can't find info in text to explain subacute, I know epidural has an initial LOC followed by recovery and subsequent LOC.

Thank you in advance........BG

[pinkiepie_RN]

Hi. Newbie here with a final coming up. I had a couple of questions about things that I can not narrow down on my own with books, notes etc. If anyone can point me in the right direction, I would be very appreciative.

Here goes.....

1. Difference b/t diffuse axonal injury and a brain stem injury. S/sx: LOC, now comatose, decerebrate posture, non-reactive pupils, abnormal respirations.

I can't find anything that discusses the difference b/t pupils in the two injuries. I am leaning towards the diffuse axonal, but still have questions.

2. Difference b/t subacute subdural hematoma and a epidural hematoma. S/sx: Fall on rt side of head, initial LOC, regained it, began to get sleepy. Rt pupil dilated. Muscle weakness.

I can't find info in text to explain subacute, I know epidural has an initial LOC followed by recovery and subsequent LOC.

Thank you in advance........BG

According to my Med-Surg text, diffuse axonal injury is widespread axonal damage occurring after a mild, moderate, or severe tramautic brain injury. My instructor explained it as basically something that happens when your brain gets really rattled. It takes 12-24 hours to develop and clinical signs include a decreased LOC, increased ICP, decorticate or decerebate posture, and global cerbral edema. 90% of these patients live in a persistent vegetative state. I can't tell you about brain stem injuries but I hope that helps.

Subdural hematomas can be subacute and reoccuring and because it is most commonly venous in origin, it is slower to develop. A subacute subdural hematoma usually occurs within 2-14 days after an injury whereas an epidural hematoma is a neurological emergency and is usually associated with a linear fracture crossing a major artery in the dura. Rapid surgical intervention is commonly indicated.

It helped me better understand this when I typed it out so I hope it makes as much sense to me as it does to you. I have a final on neuro this coming Thursday so good luck to you!