CNS Trauma Flashcards
extra-axial hemorrhage density
hyperattenuating: blood clot
water attenuation: hyperacute or clotted blood in pt with severe anemia
subarachnoid hemorrhage causes
trauma and aneurysm rupture
epidural hematoma
extra-axial hemorrhage typically due to tearing of middle meningeal artery
lentiform shape, does not cross suture lines
mass effect and herniation
venous epidural hematoma
less common; laceration to dural sinuses
posterior fossa, children
swirl sign
mixing of high/low attenuation blood within hematoma suggestive of active bleeding
subdural hematoma
crescentic extra-axial hemorrhage; extends across sutures and along falx cerebri/tentorium cerebelli
tearing of cerebral veins; increased risk in elderly pts with atrophic involutional changes since veins are stretched
complications of subdural in ventricular shunt
shunt does not function as a natural tamponade; continued bleeding
acute subdural hemorrhage
isoattenuating to gray matter
increased mass effect, white matter buckling, apparently thickened cortex
intraventricular hemorrhage
tearing of subependymal veins; exension of SAH/intraparenchymal hematoma
increased risk of noncommunicating hydrocephalus due to ependymal scarring; may obstruct aqueduct
coup/contrecoup
injury at site of impact and opposite
cortical contusion
gyral crests in a coup/contrecoup location
subacute: ring enhancement
chronic: encephalomalacia; peripheral hemosiderin on MRI; hypointense on T2; blooming artifact on GRE
intraparenchymal hematoma
cortical contusion to basal ganglia hemorrhage
diffuse axonal injury
shear-strain deformation of brain
locations: gray white junction, corpus callosum, dorsolateral midbrain
DAI imaging
CT: hemorrhage may be high attenuating
MRI: more sensitive to DAI; GRE sensitive for hemorrhagic DAI; diffusion restricted in acute DAI; FLAIR for nonhemorrhagic DAI
zygomaticomaxillary complex fractures
tripod
zygoma articulations: frontal, maxillary, temporal, sphenoid
