Page 267 - Critical Care Nursing Demystified

252 CRITICAL CARE NURSING DeMYSTIFIED

For Those Hard-to-Reach Places
An advance in scientific technology is that of Robotics. This is a method of
using computerized or automated devices along with microsurgery and laser
surgery to perform procedures or surgical functions that are too difficult or too
obscure to reach and perform manually. These are delicate devices that can
improve the control of surgical instruments by the physician such as scalpels
and laparoscopes. Robotics as a method of microsurgery is becoming increas-
ingly more popular for use by neurosurgeons to reach difficult and deep lesions
of the brain for repair and excision. Formerly inoperable and invasive tumors
can now be reached and more successfully eliminated.

Cerebral Aneurysms

What Went Wrong?
Aneurysms are usually small, berrylike sacs that are localized, abnormal dilata-
tions of an artery due to a weakness in the wall of the vessel.

Hallmark Signs and Symptoms
The patient might complain of specific symptoms such as nuchal rigidity, head- Downloaded by [ Faculty of Nursing, Chiangmai University 5.62.158.117] at [07/18/16]. Copyright © McGraw-Hill Global Education Holdings, LLC. Not to be redistributed or modified in any way without permission.
ache, vomiting, photophobia, pain behind the eye with a dilated pupil, and
ptosis of that area. However, the patient might just have a sudden unresponsive
collapse, in which case the success of surgical intervention is questionable.

Interpreting Test Results
Aneurysms can be identified via CAT scan along with sudden onset of patient
symptoms.

Prognosis
Surgical repair of a cerebral aneurysm through surgical clipping can be very suc-
cessful if identified and reached prior to the patient experiencing an actual rupture
of the aneurysm. A bypass graft replaces the segment that was the aneurysm.

Head Trauma

TBIs or traumatic brain injuries are injuries that range from mild to severe.

What Went Wrong?
Head injuries can occur in many ways such as by force or a blunt, penetrating
trauma or missile injury. These are known as primary injuries because they happen