Brain Trauma Flashcards
How can you differentiate between extradural and subdural haematoma on CT?
What is the CT difference between acute and chronic subdural haematoma?
Extradural - semi-circular shape of white
Subdural - crescent moon shaped
Acute - white
Chronic - darker as less dense with time
Explain the pattern of presentation with a extradural haematoma?
Initital LOC ->
Temporary recovery ->
Rapid deterioration
The Glasgow Coma Scale is based on 3 things; what are they?
Relate the score to the severity
- Motor
- Speech
- Visual response
<8 - severe
9-13 - moderate
13- 15 - mild
What are the signs of a basal skull fracture? (3)
Battle sign - bruising on the mastoid bone
Panda eyes - bruising around the orbit
Bleeding/CSF coming from ear
Describe the term ‘coup’ and ‘contra-coup’
Coup is the intital site of injury caused by force forwardd
Contra-coup is the injury in the opposite direction caused by the brain bouncing back against the skull
Caused by the fact that the brain floats in the skull
How can a patient be pronounced brainstem dead?
Need to be:
- not hypothermic
- on no drugs
- have no metabolic/hormonal imbalance
2 doctors need to confirm as well with no response to a whole cranial nerve exam with no response
Brainstem death means no recovery is possible
What is diffuse axon injury (DIA), why is it hard to see on CT and what kind of injury causes it?
What kind of presentation does it normally cause?
When individual axons are damaged
Appears as tiny areas of damage on CT
Shearing forces cause the injury
Coma
