Cranio-spinal injuries Flashcards
What is a concussion? What causes it? What are the symptoms?
A transient alteration of consciousness
caused by abrupt changes in momentum and rotational acceleration
presents as loss of consciousness, temporary respiratory arrest, loss of reflexes.
What is a contusion? What is the pathology?
crushing/bruising of brain tissue resulting from direct contact or from movement of brain within skull,
involves: gyri surfaces and hemorrhage w/ intact pia, potential full-thickness necrosis
What are the results after contusion?
necrosis of area, overlying meninges fibrocollagenous scarring and underlying gliosis
What is a laceration of brain? What type of trauma is associated with i?
severe head truama associated with pial surface tearing, more often associated with penetrating trauma
What is the mechanism behind diffuse axonal injury?
acute rotational acceleration or accel/decel, in which axons are damaged by shearing/tensile forces
Where on the brain does DAI occur?
Deep white matter, such as corpus callosum and brainstem.
DAI is seen as axonal swellings or spheroids in white matter, commonly demonstrated as petechial hemorrhages.
Pt is comatose when extensive
What accumulates with DAI?
amyloid precursor protein due to impaired axonal transport
What 3 things do intracranial hemorrhages depend on?
location
rate of accumulation
volume
Where do epidural hemorrhages occur? What is a common consequence?
near arterial groove: M. meningeal A, temporal/parietal bone fracture
herniation
Is the subdural space true or potential? What happens in a hemorrhage there?
potential space bw dura and arachnoid, usually involves large, bridging veins
Acute vs chronic subdural hemorrhage
acute: hours/days, severe, rapid accumulation and surgical emergency
chronic: weeks/months after head injury, recurrent bleeding of neomembrane
What are the 3 steps to organizing a subdural hematoma?
1) clot lysis,
2. ) growth of dural FB into hematoma,
3) early fibrovascular neomembrane
Skull fractures can result in what downstream effects?
petechial hemorrhages from fat emboli due to the skull fractures
How does spinal trauma develop?
hemorrhage can occur at level of injury along with necrosis and axonal swelling. Tapered above and below, the lesion eventually undergoes syringomyelia ( liquefaction necrosis and cavitation)
