Brain Flashcards
(86 cards)
Name the 3 meningeal layers suspending the brain
dura (periosteal & meningeal), arachnoid & pia
Between which two meningeal layers does the majority of cerebrospinal fluid exist?
arachnoid mater & pia mater (called the subarachnoid space)
Where does the tentorium cerebelli lie within the brain?
between the cerebellum and the posterior cerebral hemispheres
Where are the supratentorial & infratentorial compartments in the brain?
above and below the level of the tentorium cerebelli
There is a greater principal strain in the corpus callous for a coronal rotational versus sagittal rotational force, what does this mean?
Injuries which cause rotational force in the coronal direction may be more severe than those which cause rotational force in the sagittal direction
During an impact to the head, how does the skull and brain outcomes vary depending on the direction of force?
During a straight on impact to the head, the skull is able to absorb a lot of the strain, whereas during an oblique impact (shearing) the skull does not absorb as much and more strain is passed on to the brain, often resulting in more severe injury
True or false… an impact to a head that is free to move is likely to result in greater injury that an impact to a head that is constrained
True
The brain is a poroelastic, fluid-saturated solid. What does this mean?
It is a solid material containing and surrounded by fluid
Does the brain have a high or low permeability?
Low
Does the brain have a high or a low bulk modulus?
High
Bulk modulus is how much you can decrease the volume of a material by compressing it on all sides. The brain has a high bulk modulus because its volume cannot be decreased very much due to how much fluid is present
The brain has a low compressive modulus and an even lower shear modulus, what does this mean for its sensitivity to loading?
The brain is more sensitive to shear loading than compressive loading
True or false… in general white matter is stiffer than grey matter in compression
When is this not the case?
True
White matter varies directionally (anisotropic) more than grey matter (isotropic) so this may vary depending on location
I.e. the corpus callosum fibres are arranged left to right and so the way that it behaves under strain will depend on which direction you are testing (left to right or ant. to post.)
Why are humans more likely to experience injuries to the brain than quadrupeds?
Brain mass: smaller brains tolerate much greater acceleration/deceleration forces (larger brains are heavier and gain more momentum than a lighter brain)
Alignment: in quadrupeds the long axis of the brain is parallel to the spinal cord whereas in humans they are at a right angle which may increase rotational shearing forces
How many brain injuries can be attributed to motor vehicle accidents?
More than ⅔
What is the difference between a traumatic brain injury and an acquired brain injury?
An acquired brain injury is any brain injury acquired after birth (I.e. stroke, poisoning etc)
Traumatic brain injury refers to a traumatically induced structural injury &/or physiologic disruption of brain function as a result of an external force (and falls under the heading of an acquired brain injury)
What are the clinical signs of a traumatic brain injury?
Any period or loss, or a decreased level, of consciousness
Any loss of memory (of events before or after the injury)
Any alteration in mental state at the time of injury (I.e. confusion, slowed thinking)
Neurological deficits (I.e. weakness, balance, visual, speech, general sensory)
What is diffuse axonal injury (DAI)?
A widespread disruption of white matter usually due to shearing forces
When does a extradural (aka epidural) haematoma occur?
Often following a skull fracture, some broken bone may pierce the middle meningeal artery resulting in bleeding into the extradural/epidural potential space
This potential space is between the skull and the endosteal (outer) layer of dura mater
When does a subdural haematoma occur?
Often following violent shaking of the head, the bridging veins connecting to the dural sinuses can be severed resulting in bleeding into the subdural potential space (aka shaken baby syndrome)
This potential space is between the meningeal layer of dura and the arachnoid
When does a subarachnoid haematoma occur?
Either due to stroke or aneurysm or an acceleration rotational trauma, there is bleeding from the cerebral arteries and veins resulting in blood joining the CSF in the subarachnoid space
Where does an intracerebral (parenchymal) haemorrhage occur?
Within the brain tissues due to a disruption in the veins/capillaries within the brain often following an acceleration/deceleration injury
Why is brain contusion often associated with subarachnoid haemorrhage?
Often if a brain contusion has occurred it can be assumed that the impact has also damaged the vascular structures between the skull and the brain in that location, resulting in subarachnoid haemorrhage
What is brain contusion?
Focal surface bruising on the brain resulting in cell death, bleeding & oedema
What is coup and contreceoup in regards to brain contusion?
Coup refers to contusion directly under the site of impact due to compressive forces whereas contreceoup refers to contusion on the opposite side of the brain due to inertia forcing the brain into the other side of the skull