Icp unequal pupil size professional#

This equation states that the volume of blood, brain, and cerebrospinal fluid within the nonexpansile cranium must remain constant for ICP to remain constant. The Monro-Kellie doctrine governs ICP and expanding mass lesions. This patient also has evidence of increased intracranial pressure (ICP) with localizing signs, unequal pupils, and hemiparesis. Definitive airway management by endotracheal intubation is vital in the initial treatment of this patient. Due to the loss of cerebral autoregulation, the injured brain is much more susceptible to hypoxia and hypotension in brain injury patients with both hypoxia and hypotension, mortality is approximately 75%, and hypotension alone doubles the mortality risk compared to that for normotensive patients with a severe head injury. For a patient with a severe head injury, the most important management principle is avoidance of secondary brain injury. The anatomic classification of the injury is not important in the initial treatment of this patient. This patient may have an epidural hematoma, subdural hematoma, intraparenchymal injury, subarachnoid hemorrhage, diffuse axonal injury, or any combination of these injuries. Learn the emergent management for patients with intracranial mass lesions. Learn the causes and preventive measures for secondary brain injury.ģ. Be able to calculate and know the significance of the GCS score.Ģ.

Next step: Immediate endotracheal intubation to control ventilation and oxygenation.ġ.

Most likely diagnosis: Severe closed head injury with possible mass effect.

He has an initial Glasgow Coma Scale (GCS) aggregate score of 8 ( Table 12–1). Summary: A 22-year-old man has an injury mechanism and presentation indicating an isolated severe closed head injury. The results from an examination of the truncal region and extremities are within normal limits. No blood is visualized behind the tympanic membranes. The right pupil is dilated 6 mm and sluggishly reactive to light the left pupil is 4 mm in diameter and reacts normally to light. The secondary survey demonstrates a 3-cm scalp laceration and a contusion over the right temporal region. His only verbal responses are incomprehensible sounds. The patient does not open his eyes in response to voice commands but has eye opening in response to painful stimuli. During the primary survey at the emergency department, the patient has apparently normal air exchange, a respiratory rate of 18 breaths/min, blood pressure of 138/78 mm Hg, and a pulse of 80 beats/min. The paramedics placed the patient in cervical spine precautions and brought him to the emergency department. Witnesses noted that the patient was unconscious immediately after the incident and did not regain consciousness for approximately 10 minutes. Clinical Cases CASE 12Ī 22-year-old man was walking past a construction site when a brick fell off the scaffold and struck him in the head. If you think you may have a medical emergency, call your physician or 911 immediately.Case Files Surgery, (LANGE Case Files) 4th Ed.

By using this Site you agree to the following Terms and Conditions. We offer this Site AS IS and without any warranties. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site.

Icp unequal pupil size professional#

We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only.