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Intracerebral Hematoma

Terms in this set (8)

Intracerebral Hematoma
Intracerebral Hematoma, Bleeding within the brain tissue (parenchyma) itself; also referred to as an intraparenchymal hematoma
Characteristics:
bleeding within the brain - bleeding increased the volume of brain contents and ICP disrupts blood flow casuing the brain to become ischemic and hypoxic
Cause:
closed or open head injury or from a cerebraovascular condition (GSW, Deep depressed fractures, CVA, ruptured cerebral aneurysm)
Signs and Symptoms:
signs of IICP - HA, vomiting, seizures, posturing, hyperthemia, irregular breathing
Diagnostic Test:
Neuro exam - rapid severity of neuro changes depending on the location, rate of bleed, and size of hematoma, MRI/CT shows densities that indicate location of the hematoma and shifts in the cerebral tissue, ICP monitorying provided direct and continous data for evaluating the extent to shich the lesion is expanding or responding to treatment
Medical Treatment:
a rapid change in LOC and signs of uncontrolled IICP indicate surgical emergency - craniotomy (cut an opening of the skull to gain access to contents beneath cranial bones (removes blood clots, turmor, stop intracranial bleeding or repair damaged brain tissues or blood vessels), craniectomy (removal of a portion of the cranial bone), cranioplasty (reapir of a defect in a cranial bone (metal or plastic or wire mesh is used to replace the removed bone or to reinforce a defect in a cranial bone)
Nursing Management:
obtains a complete history of the injury, neuro exam, if trauma - examines head for bleeding, abrasions, and lacerations, evaluates respriratory status (maintianing adequate O2), report neuro changes ASAP
Patient Teaching:
watch for signs of intracranial bleeding and inreaction (expect swelling around the eye and below the incision), will hear clicking around aournd bone flap but disappers as it heals, HA are common, care of surgical site keep site clean and protective measures, ambulate with assistance at home, clutter free, well lit environment, no driving, exercise to promote strength and endurance, bowel and bladder techniques, feeding and nutrioanl suggestions, keep follow up appts for anitconvulsant blood levels - electrocephlograms, medical care/evaluation
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