Blue boxes: dural sinuses

Question 1

What is thrombophlebitis of the facial vein?

Answer 1

There is inflammation int eh facial vein with a secondary thrombus formation and the infected clot can cause an infection in the cavernous sinus

Question 2

What is the triangle of death on the face? Why is this the triangle of death?

Answer 2

The triangular area from the upper lip to the bridge of the nose

Question 3

How can thrombophlebitis of the facial vein occur?

Answer 3

From a laceration in the nose, to popping a pimple on the nose within the triangle of death; this can cause an infection that can spread to the cavernous sinus which is deadly because then it can get to the rest of the body

Question 4

What can happen to the dura during a blunt trauma to the head?

Answer 4

The periosteal layer can separate from the calvaria

if there is a fracture to the skull near the base, the dura can also fracture and can cause a leakage of CSF

Question 5

What is a tentorial herniation?

Answer 5

The tentorial notch is the opening for the tentorium cerebelli that goes to the brainstem

In a herniation, the temporal lobe may be lacerated by the tentorium cerebelli and the oculomotor nerve can become compressed or stretched which causes paralysis to the ocular muscles

Question 6

Describe bulging of the diaphragma sellae

Answer 6

Pituitary tumors can extend superiorly into he diaphragma sellae, which can produce endocrine disturbances and can cause compression of the optic chasm, resulting in vision changes

Question 7

Which venous sinuses are most commonly thromboses?

Answer 7

Transverse, cavernous, and superior sagittal

Question 8

Describe the metastasis of tumor cells to the dural venous sinuses

Answer 8

The intervertebral venous systems and the dural sinuses are valveless, so something that increases the pressure in the thoracic area such as heavy coughing, straining can force blood from these areas up into the dural sinuses along with the cancer cells, which are able to metastasize up there

Question 9

Describe a fracture of the cranial base that has caused an arteriovenous fistula.

Answer 9

The fracture of the cranial base has caused the internal carotid artery to be torn, and caused an influx of arterial blood into the cavernous sinus, which causes it to swell and send blood into the venous tributaries

The tributary that is most commonly affected is the ophthalmic veins, which results in the eye popping forward with notable pulses (pulsating exophthalmos)

Question 10

Which nerves are surrounding the cavernous sinus?

Answer 10

III
IV
V1
V2 
VI

Question 11

Why is it possible to get a headache following a lumbar puncture?

Answer 11

When the CSF was removed, there was a slight sag in the brain, which pulls on the dura, and causes a headache

Question 12

Describe leptomeningitis

Answer 12

Inflammation of the leptomeninges from pathogenic microorganisms; typically confined to the subarachnoid space but can travel through the blood and stuff

Question 13

Define a cerebral concussion

Answer 13

Brief loss of consciousness immediately after a severe head injury

concussion can occur without the loss of consciousness as well

Question 14

Define a cerebral contusion

Answer 14

results from brain trauma where the pia is stripped from the injured surface of the brain and may be torn, allowing the blood to enter the subarachnoid space

Question 15

What is a cerebral laceration and when does it typically occur?

Answer 15

A cerebral laceration is a laceration in the brain that causes bleeding into the brain and subarachnoid space which can increase intracranial pressure

usually caused by a depression fracture of the skull

Question 16

What are possible ways in which a cerebral compression can occur?

Answer 16

1. intracranial collection of blood
2. obstruction of CSF circulation
3. intracranial tumors or abscesses
4. brain swelling or edema

Question 17

What is a cisternal puncture

Answer 17

The LP for children and infants (rmr we don’t know where their nerves actually end in their back)

a needle is inserted into the posterior atlanto-occipital membrane into the cerebromedullary cistern to retrieve the CSF

Question 18

Describe hydrocephalus

Answer 18

1. Overproduction of CSF
2. obstruction of the flow of the CSF
3. interference with CSF absorption

Results in excess fluid in the brain ventricles and enlargement of the head by separating the bones of the calvaria in infants,

Question 19

What could occur if there is a fracture in the floor of the middle cranial fossa?

Answer 19

CSF leakage from the external acoustic meatus if the meninges superior to the middle ear is torn and the TM is ruptured

Question 20

What could occur if there is a fracture in the floor of the anterior cranial fossa

Answer 20

If there is a fracture in the cribiform plate or the ethmoid bone, then there can be leakage of CSF from the nose

Question 21

True or false: The cerebral arterial circle has several variations that can be present in people

Answer 21

TRUE

Question 22

Describe a stroke

Answer 22

Acute disruption of the normal blood flow of the brain that results in death of brain cells that results in a brain malfunction

two types are hemorrhagic which is due to bleeding and ischemic which is due to lack of blood getting to the brain

typically only cause deficits and not death

Question 23

Describe a brain infarction

Answer 23

A piece of plaque from a vessel that is clogged can get dislodged and travel into the arteries of the brain and get lodged and impede blood flow to the brain, causing that area of the brain to potentially die if there are no anastomoses to that area

Question 24

Describe a transient ischemic attack

Answer 24

Ischemia of the brain that lasts for less than 24 hours resulting in minimal neurological damage

small stroke basically but not as severe