CNS Injury 1 Flashcards
(31 cards)
Trauma is the leading cause of death to age…
45
What percent of deaths from trauma are due to head injury
33
what percent of head injury deaths occur prior to hospitalization
66
What is key in CNS trauma? Caring for?
PRIMARY PREVENTION
Peak age groups for CNS trauma
24-35
Male:Female 2:1
Causes of TBI - 5 leading in descending order
Falls Unknown / Other Struck by / Against Motor Vehicle / traffic Assaults
Ways to hurt your cerebrum
Contact phenomenon
Acceleration (Translational / Rotational)
Penetrating
Secondary to hypoxia/hypotension
Consequences of Contact phenomena (objects striking the head)
scalp laceration
subgaleal hematomas (between periosteum and aponeurosis)
skull fractures
epidural hematomas
Skull fractures are usually a consequence of
contact phenomena
Types of skull fractures (4)
linear
depressed
basilar
growing
Prognosis for basilar skull fractures
no independent prognosis other than mechanism and velocity of impact
Which skull fracture is associated with CSF leak (inparticular)
Basilar
Signs of skull base fracture (7)
CSF rhinorrhoea Bilateral periorbital hematomas Subconjunctival haemorrhage Bleeding from external auditory meatus CSF otorrhoea Battle's sign (behind ears - may take longer to develop) Facial nerve palsy
Cause of epidural hematomas?
Contact phenomena (associated with skull fractures)
Classic “lucid interval” is associated with which type of cerebral injury
epidural hematoma
Do epidural hematomas have a low or high mortality rate?
low
Translational injury - results from?
results from head movement in a single plane the instant after impact - falls, restrained occupants, starred windshields)
Translational head injury - results in
stretching and tearing of veins between the brain and dura (subdural hematoma) and bruising of the brain as it impacts the skull (contusion)
Cerebral contusions result from
acceleration (Translational) injury
which brain regions usually are impacted by cerebral contusions?
frontal and temporal
what may be consequence of cerebral contusions
may result in swelling, brain shift, increased intracranial pressure, herniation
do cerebral contusions have high or low mortality?
low
What are coup and countercoup injuries and what are they associated with?
blunt trauma
Coup = impact against object - direct trauma to brain at site of impact –> leads to shearing of subdural veins and trauma to base of brain
Countercoup = impact within skull - brain hitting opposite side of brain from trauma (rebound) –> leads to shearing forces through the brain
Both injuries occur in one continuous moition - the head strkes the wall (coup) then rebounds (contre-coup)
Subdural hematoma - due to
acceleration injury - translational
