3. Traumatic Brain and Spinal Injury Flashcards

1
Q

Where are contrecoup injuries most commonly found?

A

Roof of orbits and cribiform plates

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2
Q

What are the signs of a base of the skull fracture?

A

Racoon eyes
Battle’s sign
CSF leak from nose and ears
Haemotypanium

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3
Q

What is meant by a burst lobe?

A

When haemorrhage from a laceration extends into the subarachnoid space

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4
Q

Why does it take 2 days for an intracerebral haemorrhage to evolve?

A

Blood vessels were not initially torn but break down after 2 days
Mannitol may have been given to treat ICP originally but increase risk of haemorrhage later on

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5
Q

What is the most common sequelae of brain injury?

A

Subarachnoid haemorrhage

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6
Q

What artery can be damaged by trauma to the neck?

A

Vertebral artery

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7
Q

What shape is a extradural haematoma?

A

Lemon-shaped as doesn’t cross suture lines

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8
Q

What is the most common cause of an extradural haematoma?

A

Skull fracture of the squamous temporal bone, severing the middle meningeal artery

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9
Q

What shape is a subdural haematoma?

A

Banana-shaped

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10
Q

What is an acute subdural haematoma?

A

Rupture of bridging veins after falls and assaults

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11
Q

What does the prognosis of a subdural haematoma depend on?

A

Extent of the contusions and swelling

The blood can be reabsorbed and resolve spontaneously

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12
Q

What is a chronic subdural haematoma?

A

Unrelated to acute
A trivial head injury evolves over weeks
Granulation tissue forms a membrane around haemorrhage, high risk of rebleeding as granulation vessels are weak

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13
Q

What is the biggest risk factor for a chronic subdural haematoma?

A

Anticoagulation

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14
Q

What are the risks for intracerebral haemorrhage?

A

Amyloid

Atherosclerosis

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15
Q

What type of force causes axonal injury?

A

Angular or rotational acceleration

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16
Q

What is the clinical course of a diffuse axonal injury?

A

Unconscious at impact and remain vegetative until death

Brain can look normal at autopsy or may show petechiae on corpus collosum and dorsal brainstem

17
Q

What are the signs of diffuse axonal injury on histology?

A

Axonal swelling
Varicosities
‘Retraction’ bulbs
B-APP marker shows abnormal axonal flow

18
Q

What areas in the brain are affected first by ischaemia?

A

Hippocampus
Deep grey structures
Watershed area in cortex

19
Q

What can cause fracture or dislocation of the cord?

A

Hyperflexion/extension
Compressive forces
Rotational movements (dislocations)

20
Q

What is Chronic Traumatic Encephalopathy?

A

brain atrophy and loss of neurons due to multiple mild brain injuries
Causes neuropsychiatric and movement disorders

21
Q

How is a diagnosis of Chronic Traumatic Encephalopathy made at autopsy?

A

Aggregation of phosphorylated tau protein in astrocytes, neurons and cell processes