Summary
Samenvatting Uitwerking neurologie neonaat
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Uitgebreide uitwerking van de neurologie bij een neonaat
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OG NeurologiePeriventriculaire leukomalacie
Oorzaken PVL
- Hypoperfusie hersenen
o Hypotensie
o Hypocapnie
- Infectie
- Sepsis
- Open ductus
Ziekten die kunnen leiden tot PVL
- Solutio
- Asfyxie
- Sepsis
- Nec
- Frequentie apneu’s
Autoregulatie
- RR stijgt, dan gaat cerebrale bloedflow omhoog.
- Bij prematuren niet goed ontwikkeld
- Hoe lager de PCO2, hoe minder de cerebrale bloedflow.
- Hoe hoger de PCO2, hoe hoger de cerebrale bloedflow.
Gevolgen PVL
Motorisch:
- 75% ernstige schade
- 15% nergens last van
- 10% milde stoornis
Mentaal:
- 25% geen schade
- 40% ernstige schade
Visus
- 50% geen schade
- 30% strabismus
Preventie PVL:
- Voorkomen hypotensie
- Voorkomen hypocapnie
- Voorkomen Infecties
Hersenbloedingen
Oorzaak
- Fragiele capillairen in germinatieve laag
- Toename cbf
- Fluctuaties cbf
- Toename veneuze druk: met hogere druk beademen is ook een toename van
de veneuze druk.
- Lage PaO2 geeft een hele hoge cerebrale bloedflow
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