ca-cna-critical-care-pediatrics key terms

A 3-to-15 point scoring tool rating eye opening, verbal response, and motor response to grade level of consciousness; pediatric versions adjust verbal and motor descriptors for preverbal infants and young children.

An adapted coma scale using age-appropriate verbal and motor anchors for infants and toddlers, such as smiling, cooing, and purposeful withdrawal, so scores reflect expected developmental behavior rather than adult responses.

Cranial nerve responses such as pupillary light, corneal, oculocephalic, and gag reflexes that test brainstem integrity; their loss or asymmetry localizes injury and signals impending herniation.

The pressure exerted inside the rigid skull by brain tissue, blood, and cerebrospinal fluid; sustained elevation reduces cerebral perfusion and, untreated, causes herniation and death.

The net pressure driving blood through the brain, calculated as mean arterial pressure minus intracranial pressure; targets are age-specific because normal blood pressure rises through childhood.

The principle that the skull is a fixed container holding brain, blood, and cerebrospinal fluid, so an increase in one compartment must be offset by a decrease in another or pressure rises.

The ability of the intracranial contents to accommodate added volume without a large rise in pressure; compliance falls as compensatory reserve is exhausted, making small volume changes cause steep pressure spikes.

The average arterial pressure over the cardiac cycle, approximated as one-third systolic plus two-thirds diastolic; it is the driving pressure used with intracranial pressure to compute cerebral perfusion pressure.

A catheter placed in a lateral ventricle to measure intracranial pressure and drain cerebrospinal fluid; it also allows sampling and therapeutic pressure control, but carries infection and overdrainage risks.

A surgically implanted system routing cerebrospinal fluid from a cerebral ventricle to the peritoneal cavity to treat hydrocephalus; malfunction presents with headache, vomiting, lethargy, or acute deterioration.

Enlargement of cerebrospinal fluid spaces from impaired flow, absorption, or overproduction, raising intracranial pressure; in infants it produces a bulging fontanel and rapidly growing head.

The combination of hypertension with widened pulse pressure, bradycardia, and irregular respirations that signals critically raised intracranial pressure and brainstem compression requiring immediate intervention.

Displacement of brain tissue across intracranial compartments because of a pressure gradient; signs include pupillary asymmetry, declining consciousness, and abnormal posturing, and it is a life-threatening emergency.

Structural or functional brain damage from external mechanical force, ranging from concussion to diffuse axonal injury and hemorrhage; management targets secondary injury from hypoxia, hypotension, and raised pressure.

Progressive neuronal damage occurring hours to days after the initial insult, driven by hypoxia, hypotension, hyperthermia, seizures, and inflammation; critical care aims to prevent these preventable contributors.

Widespread shearing of axons from rotational acceleration-deceleration forces, often with normal initial imaging; it causes prolonged coma, and findings may appear later on magnetic resonance imaging.

Damage to the spinal cord from trauma, ischemia, or compression, producing motor, sensory, and autonomic deficits below the level of injury; cervical lesions may impair breathing and blood pressure control.

Loss of sympathetic vascular tone after upper spinal cord injury, causing hypotension with bradycardia or lack of reflex tachycardia; treatment includes fluids, vasopressors, and sometimes atropine.

Transient flaccid paralysis, areflexia, and loss of sensation below a spinal injury, lasting days to weeks before spasticity and reflex return; it can mask evolving neurologic deficits.

Continuous seizure activity or recurrent seizures without recovery of consciousness lasting five minutes or longer; prompt benzodiazepine treatment prevents neuronal injury and systemic complications.

Prolonged or repeated generalized tonic-clonic seizures without interictal recovery; it is a medical emergency requiring airway support, benzodiazepines, second-line antiseizure drugs, and treatment of underlying causes.

Seizures that persist despite adequate doses of a benzodiazepine and at least one second-line antiseizure medication, usually requiring continuous anesthetic infusion and intensive care monitoring.

Sustained electrographic seizure activity without obvious motor manifestations, presenting as altered consciousness or subtle twitching; diagnosis requires electroencephalography because clinical signs are easily missed.

A recording of electrical brain activity through scalp electrodes, used to detect seizures, assess background organization, and identify nonconvulsive or subclinical seizure activity in unresponsive patients.

Prolonged bedside electroencephalographic recording, often over hours to days, used in critically ill children to detect nonconvulsive seizures and guide titration of sedatives and antiseizure drugs.

A compressed trend display of electroencephalographic amplitude over time, used at the bedside in neonates and children to screen for seizures and monitor background continuity when full interpretation is unavailable.

An electroencephalographic pattern of high-amplitude bursts separated by periods of near-flat suppression, seen in deep anesthesia or severe encephalopathy and sometimes targeted deliberately for refractory seizures.

An imaging method using magnetic fields to give detailed soft-tissue contrast of brain and spinal cord; it detects edema, ischemia, and axonal injury better than computed tomography but requires safety screening.

Rapid cross-sectional X-ray imaging that readily shows acute hemorrhage, fractures, and mass effect; it is first-line in acute head trauma but exposes children to ionizing radiation.

A noninvasive monitor estimating regional cerebral oxygen saturation by shining near-infrared light through the scalp; trends may guide management of cerebral oxygenation, though absolute values are unreliable.

Ultrasound measurement of blood flow velocity in major cerebral arteries, used to detect vasospasm after hemorrhage and to assess flow patterns in elevated intracranial pressure and sickle cell disease.

Measurement of oxygen content in blood draining the brain, used to estimate the balance between cerebral oxygen delivery and consumption; low values suggest inadequate perfusion.

An indwelling arterial catheter providing continuous blood pressure measurement and access for blood sampling; it is essential for precise cerebral perfusion pressure calculation and vasoactive drug titration.

Infection of the brain, meninges, or spinal cord, including bacterial meningitis, viral encephalitis, and brain abscess; presentation in children may be nonspecific, and delays in treatment worsen outcome.

Inflammation of the meninges, usually infectious, causing fever, headache, neck stiffness, and photophobia; infants may show only irritability or a bulging fontanel, and cerebrospinal fluid analysis confirms the diagnosis.

Inflammation of brain parenchyma, often viral, producing altered mental status, seizures, and focal deficits; treatment includes supportive care, antivirals when indicated, and seizure control.

Needle sampling of cerebrospinal fluid from the lumbar subarachnoid space for cell counts, chemistry, and culture; it is deferred when raised intracranial pressure or coagulopathy makes herniation risk unacceptable.

Narrowing of cerebral arteries, most often after subarachnoid hemorrhage, causing delayed ischemic deficits; transcranial Doppler and neurologic monitoring support early detection and treatment.

Bleeding into the space between arachnoid and pia mater, often from a ruptured aneurysm or arteriovenous malformation, causing sudden severe headache, meningismus, and risk of hydrocephalus and vasospasm.

A tangled mass of abnormal arteries and veins without an intervening capillary bed, which can rupture and cause intracranial hemorrhage or seizures; treatment options include surgery, embolization, and radiosurgery.

Intracerebral bleeding from vascular malformation, aneurysm, coagulopathy, or hypertension, causing sudden focal deficits, headache, and vomiting; management targets blood pressure, pressure control, and bleeding source.

An acute immune-mediated polyneuropathy causing ascending weakness and loss of reflexes, with risk of respiratory failure and autonomic instability; treatment includes intravenous immunoglobulin or plasma exchange.

Inadequate ventilation from weakness of respiratory muscles in conditions such as Guillain-Barré syndrome, myasthenia gravis, or muscular dystrophy; declining vital capacity signals need for ventilatory support.

A life-threatening reflex in high spinal cord injury where a noxious stimulus triggers severe hypertension, headache, sweating, and bradycardia; removing the trigger and lowering blood pressure are urgent.

Breathing support delivered through a mask or nasal interface without an artificial airway; it can support children with neuromuscular weakness while preserving speech and swallowing but requires airway protection.

An acute fluctuating disturbance of attention and awareness from illness, medications, or environment; it is common in critically ill children and is managed by treating causes and reducing sedation and restraints.

A cluster of autonomic and neurologic symptoms such as agitation, sweating, tachycardia, and tremor after abrupt reduction of prolonged sedative or opioid exposure; it requires structured tapering.

A validated tool scoring arousal and agitation from unresponsive to combative, used to set and titrate sedation targets; it is applied with pain and delirium assessments in critically ill children.

A selective alpha-2 agonist providing sedation and analgesia with minimal respiratory depression; it may cause bradycardia and hypotension and is useful when extubation readiness or delirium risk matters.

An N-methyl-D-aspartate receptor antagonist providing sedation, amnesia, and analgesia while preserving spontaneous breathing; it can raise blood pressure and intracranial pressure and may cause emergence reactions.

A concentrated sodium chloride solution given to draw water out of brain tissue and lower intracranial pressure; sodium and osmolality require monitoring to avoid complications.

An osmotic diuretic used to reduce cerebral edema and intracranial pressure; it causes diuresis, can disturb electrolytes, and requires attention to renal function and volume status.

Deliberate cooling to reduce metabolic demand and limit secondary brain injury; it is used in selected neonatal encephalopathy and some refractory intracranial hypertension states, with careful temperature control.

An approach that treats the family as an essential partner in care, supporting presence, information sharing, and shared decisions; it improves satisfaction and supports the child's emotional and developmental needs.

A collaborative process in which clinicians and families exchange information about options, benefits, and values to reach a jointly chosen plan, especially when evidence is uncertain or outcomes are poor.

A person legally authorized to make health care choices for a child who cannot decide, usually a parent or guardian; decisions should follow the child's best interests and known values.

The clinical and sometimes ancillary confirmation of irreversible loss of all brain function, including brainstem reflexes and spontaneous breathing, while circulation is maintained; protocols are age-specific.

A component of brain death evaluation in which ventilation is suspended while oxygen is supplied, testing whether rising carbon dioxide provokes any respiratory effort; absence supports the diagnosis.

Prolonged states of reduced awareness after severe brain injury, including coma, vegetative state, and minimally conscious state; prognosis and rehabilitation planning depend on serial standardized assessment.

Structured preparation moving an adolescent with neurologic conditions from pediatric to adult care, addressing self-management, education, equipment, and community supports to prevent gaps in treatment.