Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4 - Nervous > Head Trauma > Flashcards

Head Trauma Flashcards

1
Q

Describe the classification of head trauma

A
  • Primary head injury is one that happens immediately after trauma
    - Focal - haematoma, contusion
    - Diffuse - concussion, diffuse axonal injury
  • Secondary head injury happens as a result of indirect injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define contusion and describe how it occurs in head trauma

A
  • Bruising of brain whereby blood mixes with cortical tissue due to microhaemorrhages and small blood vessel leaks
  • Happens when the brain strikes the skull during trauma
  • Trauma -> microhaemorrhages -> cerebral contusion -> cerebral oedema/intracerebral bleed -> raised ICP -> coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the two types of contusions

A
  • Coup - contusion at site of impact to skull
  • Contre-coup - contusion at site opposite to impact
    - Due to force of impact causing brain to bounce on opposite side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Define concussion and describe how it occurs in head trauma

A
  • Head injury with a temporary loss of brain function
  • Trauma -> stretching and injury to axons -> impaired neurotransmission, loss of ion regulation, and a reduction in cerebral blood flow -> temporary brain dysfunction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the concept of post-concussion syndrome

A
  • Symptoms that occur weeks to years after concussion
  • Due to structural damage to brain or neuronal damage
  • Problems with thinking/memory, headache, dizziness, irritability, sadness, sleeping
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Define diffuse axonal injury

A

Shearing of interface between grey and white matter following traumatic acceleration/deceleration or rotational injuries to the brain damaging the intra-cerebral axons and dendritic connections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the pathophysiology of diffuse axonal injury

A
  • Grey and white matter have different densities, which allows shearing
  • Disconnect millions of axons at the grey and white matter boundary
  • Trauma -> shearing of grey and white matter interface -> axonal death -> cerebral oedema -> raised ICP -> coma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the pathophysiology of basilar skull fractures

A
  • Bony fracture within the base of skull (temporal, occipital, sphenoid, ethmoid)
  • Trauma -> tears in the meninges -> CSF leakage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the clinical signs of a basilar skull fracture

A
  • Racoon eyes
  • CSF rhinorrhoea or CSF otorrhea due to tears in meninges leading to CSF leak
  • Battle sign - blood leakage along posterior auricular artery
  • Haemotympanum - blood in tympanic cavity
  • Bump
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the management of basilar skull fractures

A
  • Traumatic brain injury management - including ICP control
  • Elevation of depressed skull fractures
  • Persistent CSF leak management - surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Define extradural haemorrhage and its cause

A
  • Collection of blood between inner table of skull and periosteal dura mater
  • Nearly always secondary to trauma and/or skull fracture in younger patients
  • Involve a severed artery - most commonly middle meningeal artery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the clinical presentation of extradural haemorrhage

A
  • Patients present with loss of consciousness due to impact of initial injury
  • Followed by transient recovery with ongoing headache known as ‘lucid interval’
  • As haematoma enlarges, ICP will increase causing rapidly deteriorating level of consciousness
  • Cranial nerve palsies may be found on examination as brain structures herniate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Describe how extradural haemorrhages are seen on CT

A
  • Convex (lemon) shaped haemorrhage
  • Does not cross suture lines
  • Hyperdense blood seen during acute bleeding
  • Becomes darker (hypodense) hours after acute bleeding
  • Midline shift
  • Lateral ventricle smaller than normal due to compression by haematoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the management of extradural haemorrhage

A
  • Small EDH can be managed conservatively with neurological follow up
  • Large EDH requires referral to neurosurgery for craniotomy and clot evacuation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

List complications of extradural haemorrhage

A
  • Permanent brain damage
  • Coma
  • Seizures
  • Weakness
  • Pseudoaneurysm - blood vessel wall ruptures but blood contained within surrounding tissue
  • Arteriovenous fistula - abnormal connection between artery and vein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Define subdural haemorrhage and its cause

A
  • Collection of blood between meningeal dura mater and arachnoid mater
  • Bleeding occurs due to shearing forces on cortical bridging veins (connect brain to dural venous sinus)
17
Q

Describe how acute and subacute/chronic subdural haemorrhage presents

A
  • Acute SDH usually present due to head trauma
    • Neurological abnormalities common
    • Acute bleeds appear hyperdense - brighter than brain tissue on CT
    • Falx cerebri stops blood flowing to other hemisphere
  • Subacute/chronic SDH more common in the elderly with vague or absent history of head trauma
    • May present with confusion and general cognitive decline similar to dementia
      • Bleeding appears hypodense over time - darker than brain tissue
18
Q

Describe the management of subdural haemorrhages

A
  • Acute collections need immediate surgical intervention to relieve raised ICP
  • Symptomatic subacute/chronic SDH are often treated via one or more burr holes - drill into cranium to remove fluid
19
Q

Define subarachnoid haemorrhage and its cause

A
  • Collection of blood between arachnoid mater and pia mater

- Vast majority occur spontaneously secondary to ruptured berry aneurysm but may also be traumatic

20
Q

Describe the clinical presentation of subarachnoid haemorrhage

A
  • Sudden onset ‘thunderclap’ headache
  • Meningism - neck stiffness, photophobia
  • Fever
  • Loss of consciousness
  • Focal neurological deficits
  • An aneurysm or damage to posterior communicating artery and lead to visual disturbances as CN III runs next to PCA
21
Q

Describe berry aneurysms and their formation

A
  • Largely asymptomatic but symptoms may arise of compressing on nearby structures or during early stages of rupture
    • Risk factors - family history, hypertension, alcohol, abnormal connective tissue
  • Aneurysm formation normally occurs at junctions of blood vessels - turbulent flow
  • Mainly in the anterior circulation
  • Aneurysm forms due to gradual thinning of walls until blood is able to rupture from the vessel
22
Q

Describe the management of subarachnoid haemorrhage

A
  • Lumbar puncture performed to aid diagnosis - presence of RBC
    • Xanthochromia - RBC breakdown into yellow substance, which appears in CSF
  • Stabilise patient and prevent rebleeding - monitor BP
23
Q

Describe the different age groups for the 3 haemorrhage types

A
  • Extradural - usually young
  • Subdural - acute at any age, chronic usually elderly
  • Subarachnoid - typically older middle aged <60

4 - Nervous (19 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions