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Year 2 - Nervous > Pathology of head injury > Flashcards

Pathology of head injury Flashcards

1
Q

Head injury split into 2 categories

A

Primary

Secondary

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2
Q

Cause of primary head injury

A

Focal/diffuse brain trauma

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3
Q

Causes of secondary head injury (4)

A

Hypotension
Hypoxia
Infection
Haematoma

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4
Q

What scale used to initially assess head injury

A

GCS

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5
Q

GCS 3=

A

comatosed; probably brain dead

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6
Q

GCS 9-12 =

A

moderate injury

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7
Q

GCS 13-15=

A

Mild injury

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8
Q

What is punch drunk dementia

A

aka chronic traumatic encephalopathy

- in people who have suffered repeated blows to head –> progresses to dementia

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9
Q

Head lacerations often look clean cut so can mimic what

A

Incised wound

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10
Q

Types of skull fractures (5)

A 
Linear
Depressed
Comminuted (mosaic)
Ring
Contre-coup
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11
Q

Linear skull fractures are commonly found where

A

Temporo-parietal from blow to side or top of head

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12
Q

What is a depressed skull fracture

A

Focal impact pushing bone fragments inwards –> damaging meninges, vessels and brain tissue

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13
Q

What is a comminuted skull fracture

A

Fragmented skull all over

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14
Q

What is a ring skull fracture

A

Fracture line encircling foramen magnum caused by FALL FROM HEIGHT, usually landing on feet –> skull base and c spine forced together

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15
Q

What is a contre-coup skull fracture

A

Fracturing of the orbital plates (IN ANTERIOR FOSSA) caused by a fall on the BACK OF HEAD

due to Injury radiating from back to front of skull – isolated fracture in the anterior cranial fossa

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16
Q

3 types of brain haemorrhages/haematoma

A

Extradural
Subdural
Subarachnoid

17
Q

Extradural haemorrhage/haematoma is bleeding between what layers

A

Between dura and inner surface of skull, so dura is stripped off inner surface of skull

18
Q

Extradural haemorrhages classically due to bleeding from what artery + why

A

Middle meningeal

- commonly due to skull fracture at pterion where middle meningeal lies on the inner surface of

19
Q

Subdural haemorrhage/haematoma due to bleeding from what vessels

A

Small bridging veins

20
Q

Subdural haemorrhages happen slower than an extradural - why?

A

Blood accumulates under venous pressure (which is less than arterial pressure) therefore accumulates slower

  • bleeding from small bridging veins, not arteries
21
Q

Subdural haemorrhages are usually not due to skull fracture, but what?

A

Rotational or shearing forces
-created from rapid acceleration then sudden deceleration so brain impacts front on skull then backward movement causes it to impact back of skull causing the small bridging veins to tear from the forces

22
Q

Commonest cause of subarachnoid haemorrhage

A

Ruptured aneurysm, often berry aneurysms in the circle of willis

23
Q

Name 3 intrinsic brain injuries

A

Cerebral oedema
Cerebral contusion
Cerebral laceration

24
Q

What is cerebral oedema

A

Generalised brain swelling in response to focal/diffuse injury

25
Q

What is a cerebral contusion

A

aka bruising of the brain

  • damage to brain substance
  • occurs when there’s a heavy blow to the head
26
Q

What is a coup contusion

A

Contusion found directly under site of impact

27
Q

What is a contre coup contusion

A

Contusion on opposite side of the brain due to secondary brain movement

28
Q

What is a diffuse traumatic axonal injury (tDAI)

A

Tearing of axons in white matter of brain due to SERIOUS ROTATIONAL FORCES applied to brain tissue causing shearing (tearing of axons)

29
Q

Diffuse traumatic axonal injuries are often due to what scenarios (2)

A

RTAs

Fall from height

30
Q

Diagnostic investigation of diffuse traumatic axonal injury

A

Microscopy of brain tissue

31
Q

Areas of brain susceptible to diffuse traumatic axonal injury (3)

A

Corpus callosum
Post. Internal capsule
Cerebellar peduncles

Year 2 - Nervous (39 decks)

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