CEN

CEN Epididymitis Overview

Epididymitis is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Males of any age can get epididymitis. Epididymitis is most often caused by a bacterial infection, including sexually transmitted infections (STIs), such as gonorrhea or chlamydia. Sometimes, a testicle also becomes inflamed — a condition called epididymo-orchitis.

Signs and Symptoms

• A swollen, red or warm scrotum
• Testicle pain and tenderness, usually on one side, that usually comes on gradually
• Painful urination or an urgent or frequent need to urinate
• Discharge from the penis
• Pain or discomfort in the lower abdomen or pelvic area
• Blood in the semen
• Less commonly, fever

Causes

• STIs. Gonorrhea and chlamydia are the most common causes of epididymitis in young, sexually active men.
• Other infections. Bacteria from a urinary tract or prostate infection might spread from the infected site to the epididymis. Also, viral infections, such as the mumps virus, can result in epididymitis.
• Urine in the epididymis (chemical epididymitis). This condition occurs when urine flows backward into the epididymis, possibly because of heavy lifting or straining.
• Trauma. A groin injury can cause epididymitis.
• Tuberculosis. Rarely, epididymitis can be caused by tuberculosis infection.

Risk Factors

Certain sexual behaviors that can lead to STIs put you at risk of sexually transmitted epididymitis, including having:

• Sex with a partner who has an STI
• Sex without a condom
• A history of STIs

Treatment

Antibiotics are needed to treat bacterial epididymitis and epididymo-orchitis. If the cause of the bacterial infection is an STI, your sexual partner also needs treatment. Take the entire course of antibiotics prescribed by your doctor, even if your symptoms clear up sooner, to ensure that the infection is gone. You should start to feel better within 48 to 72 hours of starting an antibiotic. Resting, supporting the scrotum with an athletic strap, applying ice packs and taking pain medication can help relieve discomfort.  

CEN Pelvic Inflammatory Disease Overview

Pelvic inflammatory disease (PID) is an infection of the female reproductive organs. It most often occurs when sexually transmitted bacteria spread from your vagina to your uterus, fallopian tubes or ovaries. The signs and symptoms of pelvic inflammatory disease can be subtle or mild. Some women don't experience any signs or symptoms. As a result, you might not realize you have it until you have trouble getting pregnant or you develop chronic pelvic pain.

Signs and Symptoms

The signs and symptoms of pelvic inflammatory disease might be mild and difficult to recognize. Some women don't have any signs or symptoms. When signs and symptoms of PID are present, they most often include:

• Pain — ranging from mild to severe — in your lower abdomen and pelvis
• Abnormal or heavy vaginal discharge that may have an unpleasant odor
• Abnormal uterine bleeding, especially during or after intercourse, or between menstrual cycles
• Pain during intercourse
• Fever, sometimes with chills
• Painful, frequent or difficult urination

Causes

Many types of bacteria can cause PID, but gonorrhea or chlamydia infections are the most common. These bacteria are usually acquired during unprotected sex. Less commonly, bacteria can enter your reproductive tract anytime the normal barrier created by the cervix is disturbed. This can happen during menstruation and after childbirth, miscarriage or abortion. Rarely, bacteria can also enter the reproductive tract during the insertion of an intrauterine device (IUD) — a form of long-term birth control — or any medical procedure that involves inserting instruments into the uterus.

Risk Factors

• Being a sexually active woman younger than 25 years old
• Having multiple sexual partners
• Being in a sexual relationship with a person who has more than one sex partner
• Having sex without a condom
• Douching regularly, which upsets the balance of good versus harmful bacteria in the vagina and might mask symptoms
• Having a history of pelvic inflammatory disease or a sexually transmitted infection

Treatment

• Antibiotics. Your doctor will prescribe a combination of antibiotics to start immediately. After receiving your lab test results, your doctor might adjust your prescription to better match what's causing the infection. You'll likely follow up with your doctor after three days to make sure the treatment is working. Be sure to take all of your medication, even if you start to feel better after a few days.
• Treatment for your partner. To prevent reinfection with an STI, your sexual partner or partners should be examined and treated. Infected partners might not have any noticeable symptoms.
• Temporary abstinence. Avoid sexual intercourse until treatment is completed and symptoms have resolved.

 

CEN Testicular Torsion Overview

Testicular torsion occurs when a testicle rotates, twisting the spermatic cord that brings blood to the scrotum. The reduced blood flow causes sudden and often severe pain and swelling. Testicular torsion is most common between ages 12 and 18, but it can occur at any age, even before birth. Testicular torsion usually requires emergency surgery. If treated quickly, the testicle can usually be saved. But when blood flow has been cut off for too long, a testicle might become so badly damaged that it has to be removed.

Signs and Symptoms

• Sudden, severe pain in the scrotum — the loose bag of skin under your penis that contains the testicles
• Swelling of the scrotum
• Abdominal pain
• Nausea and vomiting
• A testicle that's positioned higher than normal or at an unusual angle
• Frequent urination
• Fever

Causes

Testicular torsion occurs when the testicle rotates on the spermatic cord, which brings blood to the testicle from the abdomen. If the testicle rotates several times, blood flow to it can be entirely blocked, causing damage more quickly. It's not clear why testicular torsion occurs. Most males who get testicular torsion have an inherited trait that allows the testicle to rotate freely inside the scrotum. This inherited condition often affects both testicles. But not every male with the trait will have testicular torsion. Testicular torsion often occurs several hours after vigorous activity, after a minor injury to the testicles or while sleeping. Cold temperature or rapid growth of the testicle during puberty also might play a role.

Risk Factors

• Age. Testicular torsion is most common between ages 12 and 18.
• Previous testicular torsion. If you've had testicular pain that went away without treatment (intermittent torsion and detorsion), it's likely to occur again. The more frequent the bouts of pain, the higher the risk of testicular damage.
• Family history of testicular torsion

Complications

• Damage to or death of the testicle. When testicular torsion is not treated for several hours, blocked blood flow can cause permanent damage to the testicle. If the testicle is badly damaged, it has to be surgically removed.
• Inability to father children. In some cases, damage or loss of a testicle affects a man's ability to father children.

Treatment

Surgery is required to correct testicular torsion. In some instances, the doctor might be able to untwist the testicle by pushing on the scrotum (manual detorsion). But you'll still need surgery to prevent torsion from occurring again. Surgery for testicular torsion is usually done under general anesthesia. During surgery, your doctor will make a small cut in your scrotum, untwist your spermatic cord, if necessary, and stitch one or both testicles to the inside of the scrotum. The sooner the testicle is untwisted, the greater the chance it can be saved. After six hours from the start of pain, the chances of needing testicle removal are greatly increased. If treatment is delayed more than 12 hours from the start of pain, there is at least a 75 percent chance of needing testicle removal.  

CEN Myasthenia Gravis Overview

Myasthenia gravis is characterized by weakness and rapid fatigue of any of the muscles under your voluntary control. It's caused by a breakdown in the normal communication between nerves and muscles. There's no cure for myasthenia gravis, but treatment can help relieve signs and symptoms, such as weakness of arm or leg muscles, double vision, drooping eyelids, and difficulties with speech, chewing, swallowing and breathing. Though this disease can affect people of any age, it's more common in women younger than 40 and in men older than 60.

Signs and Symptoms

Muscle weakness caused by myasthenia gravis worsens as the affected muscle is used. Because symptoms usually improve with rest, muscle weakness can come and go. However, the symptoms tend to progress over time, usually reaching their worst within a few years after the onset of the disease.

• Ptosis
• Diplopia
• Impaired speaking
• Difficulty swallowing and chewing

Causes

• Antibodies
• Thymus glands

Complications

Complications of myasthenia gravis are treatable, but some can be life-threatening.

• Myasthenic crisis
• Thymus gland tumors
• Underactive or Overactive thyroid
• Autoimmune conditions

Treatment 

Various treatments, alone or in combination, can relieve symptoms of myasthenia gravis. Your treatment will depend on your age, how severe your disease is and how fast it's progressing.

• Cholinesterase inhibitors
• Corticosteroids
• Immunosuppressants
• IV therapy
• Surgery

 

CEN Ectopic Pregnancy Overview

Pregnancy begins with a fertilized egg. Normally, the fertilized egg attaches to the lining of the uterus. An ectopic pregnancy occurs when a fertilized egg implants and grows outside the main cavity of the uterus. An ectopic pregnancy most often occurs in a fallopian tube, which carries eggs from the ovaries to the uterus. This type of ectopic pregnancy is called a tubal pregnancy. Sometimes, an ectopic pregnancy occurs in other areas of the body, such as the ovary, abdominal cavity or the lower part of the uterus (cervix), which connects to the vagina. An ectopic pregnancy can't proceed normally. The fertilized egg can't survive, and the growing tissue may cause life-threatening bleeding, if left untreated.

Signs and Symptoms

You may not notice any symptoms at first. However, some women who have an ectopic pregnancy have the usual early signs or symptoms of pregnancy — a missed period, breast tenderness and nausea. If you take a pregnancy test, the result will be positive. Still, an ectopic pregnancy can't continue as normal. As the fertilized egg grows in the improper place, signs and symptoms become more noticeable.

Causes

A tubal pregnancy — the most common type of ectopic pregnancy — happens when a fertilized egg gets stuck on its way to the uterus, often because the fallopian tube is damaged by inflammation or is misshapen. Hormonal imbalances or abnormal development of the fertilized egg also might play a role.

Risk Factors

• Previous ectopic pregnancy
• Inflammation or infection
• Fertility treatments
• Tubal surgery
• Choice of birth control
• Smoking

Complications

An ectopic pregnancy can cause your fallopian tube to burst open. Without treatment, the ruptured tube can lead to life-threatening bleeding.

Treatment

A fertilized egg can't develop normally outside the uterus. To prevent life-threatening complications, the ectopic tissue needs to be removed. Depending on your symptoms and when the ectopic pregnancy is discovered, this may be done using medication, laparoscopic surgery or abdominal surgery.  

CEN Tympanic Membrane Rupture

A ruptured eardrum — or perforated tympanic membrane as it's medically known — is a hole or tear in your eardrum, the thin tissue that separates your ear canal from your middle ear.  A ruptured eardrum can result in hearing loss. A ruptured eardrum can also make your middle ear vulnerable to infections or injury.  A ruptured eardrum usually heals within a few weeks without treatment. Sometimes, however, a ruptured eardrum requires a procedure or surgical repair to heal.

Signs and Symptoms

Signs and symptoms of a ruptured eardrum may include:

• Ear pain that may subside quickly
• Clear, pus-filled or bloody drainage from your ear
• Hearing loss
• Ringing in your ear (tinnitus)
• Spinning sensation (vertigo)
• Nausea or vomiting that can result from vertigo

Causes

Causes of a ruptured, or perforated, eardrum may include:

• Middle ear infection (otitis media). A middle ear infection often results in the accumulation of fluids in your middle ear. Pressure from these fluids can cause the eardrum to rupture.

• Barotrauma. Barotrauma is stress exerted on your eardrum when the air pressure in your middle ear and the air pressure in the environment are out of balance. If the pressure is severe, your eardrum can rupture. Barotrauma is also called airplane ear because it's most often caused by air pressure changes associated with air travel. Other events that can cause sudden changes in pressure — and possibly a ruptured eardrum — include scuba diving and a direct blow to the ear, such as the impact of an automobile air bag.
• Loud sounds or blasts (acoustic trauma). A loud sound or blast, as from an explosion or gunshot — essentially an overpowering sound wave — can cause a tear in your eardrum.

• Foreign objects in your ear. Small objects, such as a cotton swab or hairpin, can puncture or tear the eardrum.

• Severe head trauma. Severe injury, such as skull fracture, may cause the dislocation or damage to middle and inner ear structures, including your eardrum.

Complications

Your eardrum (tympanic membrane) has two primary roles:

• Hearing. When sound waves strike it, your eardrum vibrates — the first step by which structures of your middle and inner ears translate sound waves into nerve impulses.

• Protection. Your eardrum also acts as a barrier, protecting your middle ear from water, bacteria and other foreign substances.

• Hearing loss. Usually, hearing loss is temporary, lasting only until the tear or hole in your eardrum has healed. The size and location of the tear can affect the degree of hearing loss.

• Middle ear infection (otitis media). A perforated eardrum can allow bacteria to enter your ear. If a perforated eardrum doesn't heal or isn't repaired, you may be vulnerable to ongoing (chronic) infections that can cause permanent hearing loss.

• Middle ear cyst (cholesteatoma). A cholesteatoma is a cyst in your middle ear composed of skin cells and other debris. Ear canal debris normally travels to your outer ear with the help of ear-protecting earwax. If your eardrum is ruptured, the skin debris can pass into your middle ear and form a cyst. A cholesteatoma provides a friendly environment for bacteria and contains proteins that can damage bones of your middle ear.

Diagnosis

•  Laboratory tests. If there's discharge from your ear, your doctor may order a laboratory test or culture to detect a bacterial infection of your middle ear.

• Tuning fork evaluation. Tuning forks are two-pronged, metal instruments that produce sounds when struck. Simple tests with tuning forks can help your doctor detect hearing loss. A tuning fork evaluation may also reveal whether hearing loss is caused by damage to the vibrating parts of your middle ear (including your eardrum), damage to sensors or nerves of your inner ear, or damage to both.

• Tympanometry. A tympanometer uses a device inserted into your ear canal that measures the response of your eardrum to slight changes in air pressure. Certain patterns of response can indicate a perforated eardrum.

• Audiology exam. If other hearing tests are inconclusive, your doctor may order an audiology exam, a series of strictly calibrated tests conducted in a soundproof booth that measure how well you hear sounds at different volumes and pitches.

Treatment

Most perforated eardrums heal without treatment within a few weeks. Your doctor may prescribe antibiotic drops if there's evidence of infection. If the tear or hole in your eardrum doesn't heal by itself, treatment will involve procedures to close the perforation. These may include:

• Eardrum patch. If the tear or hole in your eardrum doesn't close on its own, an ENT specialist may seal it with a patch. With this office procedure, your ENT may apply a chemical to the edges of the tear to stimulate growth and then apply a patch over the hole. The procedure may need to be repeated more than once before the hole closes.

• Surgery. If a patch doesn't result in proper healing or your ENT determines that the tear isn't likely to heal with a patch, he or she may recommend surgery. The most common surgical procedure is called tympanoplasty. Your surgeon grafts a tiny patch of your own tissue to close the hole in the eardrum. This procedure is done on an outpatient basis, meaning you can usually go home the same day unless medical anesthesia conditions require a longer hospital stay.

 

CEN Pancreatitis Overview

Pancreatitis is inflammation in the pancreas. The pancreas is a long, flat gland that sits tucked behind the stomach in the upper abdomen. The pancreas produces enzymes that assist digestion and hormones that help regulate the way your body processes sugar (glucose).  Pancreatitis can occur as acute pancreatitis — meaning it appears suddenly and lasts for days. Or pancreatitis can occur as chronic pancreatitis, which describes pancreatitis that occurs over many years.  Mild cases of pancreatitis may go away without treatment, but severe cases can cause life-threatening complications.

Signs and Symptoms

Signs and symptoms of pancreatitis may vary, depending on which type you experience. Acute pancreatitis signs and symptoms include:

• Upper abdominal pain
• Abdominal pain that radiates to your back
• Abdominal pain that feels worse after eating
• Nausea
• Vomiting
• Tenderness when touching the abdomen

• Upper abdominal pain
• Losing weight without trying
• Oily, smelly stools (steatorrhea)

Causes

Pancreatitis occurs when digestive enzymes produced in your pancreas become activated while inside the pancreas, causing damage to the organ. During normal digestion, the inactivated pancreatic enzymes move through ducts in your pancreas and travel to the small intestine, where the enzymes become activated and help with digestion. In pancreatitis, the enzymes become activated while still in the pancreas. This causes the enzymes to irritate the cells of your pancreas, causing inflammation and the signs and symptoms associated with pancreatitis. A number of causes have been identified for acute pancreatitis and chronic pancreatitis, including:

• Alcoholism
• Gallstones
• Abdominal surgery
• Certain medications
• Cigarette smoking
• Cystic fibrosis
• Endoscopic retrograde cholangiopancreatography (ERCP), when used to treat gallstones
• Family history of pancreatitis
• High calcium levels in the blood (hypercalcemia), which may be caused by an overactive parathyroid gland (hyperparathyroidism)
• High triglyceride levels in the blood (hypertriglyceridemia)
• Infection
• Injury to the abdomen
• Pancreatic cancer

Complications

• Pseudocyst. Acute pancreatitis can cause fluid and debris to collect in cyst-like pockets in your pancreas. A large pseudocyst that ruptures can cause complications such as internal bleeding and infection.

• Infection. Acute pancreatitis can make your pancreas vulnerable to bacteria and infection. Pancreatic infections are serious and require intensive treatment, such as surgery to remove the infected tissue.

• Breathing problems. Acute pancreatitis can cause chemical changes in your body that affect your lung function, causing the level of oxygen in your blood to fall to dangerously low levels.

• Diabetes. Damage to insulin-producing cells in your pancreas from chronic pancreatitis can lead to diabetes, a disease that affects the way your body uses blood sugar.

• Kidney failure. Acute pancreatitis may cause kidney failure, which can be treated with dialysis if the kidney failure is severe and persistent.

• Malnutrition. Both acute and chronic pancreatitis can cause your pancreas to produce fewer of the enzymes that are needed to break down and process nutrients from the food you eat. This can lead to malnutrition, diarrhea and weight loss, even though you may be eating the same foods or the same amount of food.

• Pancreatic cancer. Long-standing inflammation in your pancreas caused by chronic pancreatitis is a risk factor for developing pancreatic cancer.

Treatments

• Hospitalization
• Pain meds
• IV fluids
• Surgery
• Treat the underlying cause

 

Basilar Skull Fracture Overview For CEN Exam

Overview

A basilar skull fracture (or basal skull fracture) is a fracture of the base of the skull, typically involving the temporal bone, occipital bone, sphenoid bone, and/or ethmoid bone.  This type of fracture is rare, occurring as the only fracture in just 4% of severe head injury patients.  Such fractures can cause tears in the membranes surrounding the brain, or meninges, with resultant leakage of the cerebrospinal fluid (CSF). The leaking fluid may accumulate in the middle ear space, and dribble out through a perforated eardrum (CSF otorrhea) or into the nasopharynx via the eustachian tube, causing a salty taste. CSF may also drip from the nose (CSF rhinorrhea) in fractures of the anterior skull base, yielding a halo sign. These signs are characteristic for basilar skull fractures. Basilar skull fractures include breaks in the posterior skull base or anterior skull base. The former involve the occipital bone, temporal bone, and portions of the sphenoid bone; the latter, superior portions of the sphenoid and ethmoid bones. The temporal bone fracture is encountered in 75% of all basilar skull fractures and may be longitudinal, transverse or mixed, depending on the course of the fracture line in relation to the longitudinal axis of the pyramid. Bones may be broken around the foramen magnum, the hole in the base of the skull through which the spinal cord exits and becomes the brain stem, creating the risk that blood vessels and nerves exiting the hole may be damaged. Due to the proximity of the cranial nerves, injury to those nerves may occur.  This can cause palsy of the facial nerve or oculomotor nerve or hearing loss due to damage of cranial nerve VIII.

Signs and symptoms

• Battle's sign -- bruising of the mastoid process of the temporal bone.
• Raccoon eyes -- bruising around the eyes, i.e. "black eyes"
• Cerebrospinal fluid rhinorrhea
• Cranial nerve palsy
• Bleeding (sometimes profuse) from the nose and ears
• Hemotympanum
• Conductive or perceptive deafness, nystagmus, vomitus
• In 1-10% of patients, optic nerve entrapment occurs.  The optic nerve is compressed by the broken skull bones, causing irregularities in vision.
• Serious cases usually result in death

Treatment

• Surgical Intervention

• Adults with simple linear fractures who are neurologically intact do not require any intervention and may even be discharged home safely and asked to return if symptomatic. Infants with simple linear fractures should be admitted for overnight observation regardless of neurological status.^[25] Neurologically intact patients with linear basilar fractures also are treated conservatively, without antibiotics. Temporal bone fractures are managed conservatively, at least initially, because tympanic membrane rupture usually heals on its own.

• Simple depressed fractures in neurologically intact infants are treated expectantly. These depressed fractures heal well and smooth out with time, without elevation. Seizure medications are recommended if the chance of developing seizures is higher than 20%. Open fractures, if contaminated, may require antibiotics in addition to tetanus toxoid. Sulfisoxazole is a common recommendation.

 

CEN Otitis Media Overview

Otitis media is a group of inflammatory diseases of the middle ear.  The two main types are acute otitis media (AOM) and otitis media with effusion (OME).  AOM is an infection of abrupt onset that usually presents with ear pain. In young children this may result in pulling at the ear, increased crying, and poor sleep. Decreased eating and a fever may also be present. OME is typically not associated with symptoms.  Occasionally a feeling of fullness is described. It is defined as the presence of non-infectious fluid in the middle ear for more than three months. Chronic suppurative otitis media (CSOM) is middle ear inflammation of greater than two weeks that results in episodes of discharge from the ear. It may be a complication of acute otitis media. Pain is rarely present.  All three may be associated with hearing loss.  The hearing loss in OME, due to its chronic nature, may affect a child's ability to learn.

Signs and Symptoms

• An integral symptom of acute otitis media is ear pain; other possible symptoms include fever, and irritability (in infants). Since an episode of otitis media is usually precipitated by an upper respiratory tract infection (URTI), there often are accompanying symptoms like cough and nasal discharge.

• Discharge from the ear can be caused by acute otitis media with perforation of the ear drum, chronic suppurative otitis media, tympanostomy tube otorrhea, or acute otitis externa. Trauma, such as a basilar skull fracture, can also lead to discharge from the ear due to cerebral spinal drainage from the brain and its covering (meninges).

Causes

• The common cause of all forms of otitis media is dysfunction of the Eustachian tube.  This is usually due to inflammation of the mucous membranes in the nasopharynx, which can be caused by a viral URI, strep throat, or possibly by allergies. 

• Because of the dysfunction of the Eustachian tube, the gas volume in the middle ear is trapped and parts of it are slowly absorbed by the surrounding tissues, leading to negative pressure in the middle ear.

• Eventually the negative middle-ear pressure can reach a point where fluid from the surrounding tissues is sucked in to the middle ear's cavity (tympanic cavity), causing a middle-ear effusion.

• By reflux or aspiration of unwanted secretions from the nasopharynx into the normally sterile middle-ear space, the fluid may then become infected — usually with bacteria. The virus that caused the initial URI can itself be identified as the pathogen causing the infection.

Risk Factors

Risk factors for otitis media include:

• Age. Children between 6 to 36 months are most likely to get ear infections.
• Attending daycare
• Recent illness, such as a cold or sinus infection.
• History of allergies, like hay fever, also called allergic rhinitis, or sinusitis.
• Exposure to secondhand smoke
• Having family members who are prone to ear infections; studies show a clear genetic component for recurrent otitis media.
• Using a pacifier
• Having a history of gastroesophageal reflux disease (GERD).

Treatment

• Treat infections with antibiotics
• Pain meds for pain management
• Prevent future infections

 

 

CEN Brain Herniation - Overview

Brain herniation is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the brain is squeezed across structures within the skull. The brain can shift across such structures as the falx cerebri, the tentorium cerebelli, and even through the foramen magnum (the hole in the base of the skull through which the spinal cord connects with the brain). Herniation can be caused by a number of factors that cause a mass effect and increase intracranial pressure (ICP): these include traumatic brain injury, intracranial hemorrhage, or brain tumor. Herniation can also occur in the absence of high ICP when mass lesions such as hematomas occur at the borders of brain compartments. In such cases local pressure is increased at the place where the herniation occurs, but this pressure is not transmitted to the rest of the brain, and therefore does not register as an increase in ICP.^[2] Because herniation puts extreme pressure on parts of the brain and thereby cuts off the blood supply to various parts of the brain, it is often fatal. Therefore, extreme measures are taken in hospital settings to prevent the condition by reducing intracranial pressure, or decompressing (draining) a hematoma which is putting local pressure on a part of the brain.

Classification

The tentorium is an extension of the dura mater that separates the cerebellum from the cerebrum. There are two major classes of herniation: supratentorial and infratentorial. Supratentorial herniation is of structures normally above the tentorial notch and infratentorial is of structures normally below it. Supratentorial herniation

• Uncal (transtentorial)
• Central
• Cingulate (subfalcine/transfalcine)
• Transcalvarial
• Tectal (posterior)

Infratentorial herniation

• Upward (upward cerebellar or upward transtentorial)
• Tonsillar (downward cerebellar)

Signs and Symptoms

• Abnormal posturing
• Altered LOC
• Nausea and vomiting
• Dilated pupils

Treatment

• Treatment involves removal of the etiologic mass and decompressive craniectomy
• Ventriculostomy
• Mechanical ventilation
• Monitor ICP