Flashcards in 25. Neuropath: Trauma Deck (47)
what are the high and low scores for the GCS?
what types of responses does the GCS take into account?
eye response, verbal response, motor response
reversible loss of neuronal function.
totally reversible, transient, may be associated with brief LOC or postural tone.
direct bruising of the brain, disruption of the brain parenchyma
early v later symptoms of concussion?
early: HA, N/V, dizziness
late: low grade HA, blurry vision, hearling loss, irritability, poor attention....
Primary v secondary damage to the brain?
primary: direct damage to the brain, immediate. laceration, fracture, contusion, etc
secondary: not immediate, sequelae of trauma, can be more devastating. ischemia, hypoxia, swelling, infection.
diffuse axonal injury: primary or secondary?
primary. occurs at time of trauma
open v closed CNS trauma?
open: skull or skin is broken, exposed
closed: no exposure
dense, tough collagenous tissue that sits on a layer of CT that is right on the periosteum
blood collects in loose CT between galeal layer and skull.
what is a site of fracture that can open up the MMA?
temple area, where there is a cranial suture line. MMA runs in the dura right under that, and a fracture can rip open the artery --> epidural hematoma.
what are included in the category of focal injuries?
contusions, lacerations, hematomas, focal damage due to expanding masses.
where do contusions tend to do damage? what happens there?
on the crowns of the gyri. can be punctate hemorrhages, then clot off, then ischemia and tissue dies. scarring may cause later seizures.
where are contusions likely to occur?
anterior/undersurfaces of the frontal lobe and temporal lobes.
are the sulci affected by contusions?
not usually; usually it is the crowns of the gyri and tissue immediately surrounding.
what is it called when dead tissue is removed from the location of a contusion?
plaques jeunes. brain matter looks constricted, tan in color.
what else will cause plaques jeunes?
nothing except trauma. (not inflammation, infarction, tumor)
why does the brain tend to sustain coup-counter coup injuries?
it is not well attached to the skull, has a lot of room to slosh around.
subarachnoid bleeding that is traumatic is usually associated with what?
contusions, penetrating injuries.
subarachnoid bleeding that is non-traumatic is usually associated with what?
rupture of a berry aneurysm
Epidural hemorrhage is associated with what kind of trauma?
fracture to lateral surface of skull, damaged MMA.
epidural hemorrhage: blood is under high or low pressure?
usually a broken artery; high pressure.
epidural: the blood collects between what layers?
skull and dura
subdural: blood collects between what layers?
dura and arachnoid.
epidural: blood collects quickly or slowly?
quickly; within minutes to hour.
epidural: shape of accumulation? ends at sutures or not?
lens-shaped (like a clam). stops at suture lines where dura is tacked to skull.
subdural hemorrhage: shape of accumulation? ends at sutures or not?
crescent shaped. does not end at suture lines.
subdural: what kind of bleed? fast/slow?
venous (usually bridging veins). slow bleed. may not present for a few days.
if continues to bleed, can get brain shift and subfalcine herniation.