5. Dural Sinuses Clinical applications Flashcards
How does a rupture of the middle meningeal artery occur? What happens when there is a rupture of the middle meningeal artery?
It can occur from getting hit in the pterion, which is a weak portion in the skull due to the various fusion lines
If this happens and a bone breaks, then there is a chance that the bone fragment will pierce through the middle meningeal artery and cause it to rutpure.
This causes a epidural hematoma
How does a rupture of the briging vein occur? What is the result?
Subdural hematoma
Common in deceleration and acceleration injuries in the elderly
Shaken baby syndrome also causes a subdural hematoma
Describe an aneurysm in the brain.
- where do most of the aneurysms occur?
- Who is most susceptible?
- What happens if an aneurysm ruptures?
An Aneurysm is the stretching of a blood vessel, causing the blood to pool
- 40% of aneuryms occur at the jubnction of the anterior comunicating artery, 20% at the junction of the posterior communicating artery with the middle cerebral artery
- Post menopausal women are susceptible as well as patients with polycystic kidney diease and HTN
- The arteries lay in the subarachnoid space which damages the meningeal layers
What is pictured?
Epidural hematoma
It appears as a lens shape because the dura mater is tightly adhered to the suture lines, and so the bleeding tends to follow the lines as well
*** middle meningeal artery
What is pictured?
Subdural hematoma
Appears as a cresent shape below the dura. It is able to spread out because it is not constricted by the suture lines
***bridging veins
What is pictured?
Subarachnoid hemorrhage
Appears as a spider web shape from the center of the brain
***cerebral arteries
Describe cavernous sinus thrombosis
A blood clot forms from a vein that is running through the cavernous sinus and effects the cranial nerves that surround the sinus
What are the clinical sx that are associated with cavernous sinus thrombosis?
High fever
Periorbital edema
Cranial nerve palsies
decreased visual acuity
What is pictured?
Cavernous sinus thrombosis
Describe a cleft palate
Incomplete closure of the palatine bone; or poor development of the palatine bone that causes problems with speech and swallowing
Describe a Le Fort 1 fracture
Fracture of the floor of the maxilla that goes posteriorly
separation of the hard palate from the upper maxilla due to a fracture that runs through the maxilla and pterygoid plates at a level just above the floor od the nose
Describe a Le fort II fracture
Goes through the zygomaticomaxillary suture and takes a medial section of the orbit
goes through the nasal bones, medial anterior orbital walls, orbital floor, inferior orbital rims and posterior maxilla and pterygoid plates
Describe a Le Fort III fracture
Results in a craniofacial disjunction
Takes the entire zygomatic and more of the orbit
Describe the lucid interval that can occur with head trauma
after you get hit in the head, patients can feel fine for a few hours with a minor headache
Blood is filling up the epidural space and when it reaches threshold the brain cannot take anymore and then there is a herniation of the brain
