Week 4: Intro to Neurotrauma Flashcards

1
Q

In neuro trauma, the most important part of the cranial CT

scan to assess is

A

if there is midline shift.

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2
Q

Why there a need to assess if there is a midline shift?

A

The structures that lie within the midline are parts of your
thalamus, parts of your brain stem but more importantly the
Ascending Reticular Activating System.

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3
Q

Easier way to assess midline shift is to

A

draw a straight light from the falx

and measure the distance from the midline.

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4
Q

what is the significant value in assessing the midline shift?

A

Anything
greater than 6mm or 0.6cm is deadly. It is significant, it
has a 66% mortality rate.

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5
Q

What are the indications for surgery for fractures if it is

depressed?

A

If it is depressed there is greater likelihood that the
dura is perforated or lacerated. If the dura is lacerated
there is communication between the external
environment and the brain. So there is a 37% chance
of meningitis. So you need to do surgery on that.

There is significant pneumocephalus greater than 1cm. so maari magkaroon ng Tension Pneumocephalus.

If there is an underlying hematoma that is surgical

A female with cosmetic defect.

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6
Q

is commonly seen in neurosurgical patients following head trauma or following intracranial surgery

A

Pneumocephalus

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7
Q

occurs when the intracranial air pocket is under tension which can result in life threatening herniation if left untreated

A

Tension pneumocephalus

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8
Q

Indications for surgery in epidural hematomas?

A

If it is greater than 30cc there is significant midline shift and it is 15 mm thick

If the patient has anisocoria. If you have anisocoria your CN III, mid brain, ascending reticular activating system are compress. Do surgery STAT.

30 cc is the magic number. Everything 30cc kapag sa brain it is surgical.

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9
Q

It is hematoma between the skull and the dura. Remember the brain is not affected but it can cause significant midline shift.

accumulation of blood between the skull and the dura.

usually results from arterial disruption, especially of the middle meningeal artery

A

Epidural hematoma

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10
Q

Epidural hematomas have hihger mortality rate compared to your subdural hematoma. T or F?

A

F. Lower

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11
Q

The patient is initially unconscious from the concussive aspect of the head trauma. The patient then awakens and has a “lucid interval,” while the hematoma subclinically expands. As the volume of the hematoma grows, the decompensated region of the pressure volume curve is reached, ICP increases, and the patient rapidly becomes lethargic and herniates.

A

Epidural hematoma`

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12
Q

is the result of an accumulation of blood between the arachnoid membrane and the dura.

usually results from venous bleeding, typically from tearing of a bridging vein running from the cerebral cortex to the dural sinuses.

A

Subdural hematomas

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13
Q

crescent shaped lesions

A

subdural hematomas

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14
Q

it possess a higher mortality rate 50% and they have significant midline shift.

A

Subdural hematomas

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15
Q

is a collection of blood breakdown products that is at least 2 to 3 weeks old. Acute hematomas are bright white (hyperdense) on CT scan for approximately 3 days, after which they fade to isodensity with brain, and then to hypodensity after 2 to 3 weeks.

A

Chronic SDH

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16
Q

If it’s subacute or chronic you can do a burr hole. T or F?

A

T

17
Q

A ___________ can effectively drain most chronic SDHs.

A

simple burr hole

18
Q

most often associated with hypertensive hemorrhage or arteriovenous malformations (AVMs).

A

Isolated hematomas within the brain parenchyma

19
Q

that is a subdural hematoma and an intracerebral hematoma – this is what we called a

A

Burst lobe

20
Q

Cerebral Hematoma –
 Subdural Hematoma -
 Epidural Hematoma –

mortality rates?

A

27
59
15

21
Q

posterior fossa mass are Located near the brainstem or near the cerebellum you need to be more aggressive because there is rapid deterioration. T or F?

A

T

22
Q

If there is an ongoing enlargement of the hematoma or patients develop brain edema or cerebellar edema maiipit kaagad ang brainstem. Your brainstem will herniate mamatay kaagad ang patient. T or F?

A

T`

23
Q

If the 4th ventricle is distorted or loss automatically you do surgery. T or F?

A

T

24
Q

Posterior fossa lesions such as tumors, hemorrhage, or stroke can cause mass effect that can rapidly kill the patient in two ways. what are those?

A

obstructive hydrocephalus

direct brainstem compression