DSA 23 Head and Spine Trauma

Question 1

dazed, confused, saw stars

Answer 1

concussion

Question 2

is there amnesia in someone with a concussion?

Answer 2

yes

Question 3

What is the physical examination features of someone who has a concussion?

Answer 3

NORMAL neurological exam

Question 4

What is the mechanism of a concussion?

Answer 4

biochemical and ultrastructual abnormalities such as mitochondrial ATP depletion, and local disruption of blood bbrain barrier; RAS suffers the brunt of the trauma

Question 5

What are the labs like in someone with a concussion?

Answer 5

normal

Question 6

history of anticoagulant or antiplatelet use in someone who is elderly is at risk for??

Answer 6

subdural hematoma

Question 7

What would you see on a brain CT for someone who has a subdural hematoma?

Answer 7

acute; blood in the subdural space
chronic; there may be water density fluid in the subdural space

you see a crescent_shaped hemorrhage that crosses the suture lines with a midline shift

Question 8

What is the prognosis of a acute subdural hematoma?

Answer 8

lethal; if it was chronic it would be a gradual progressive condition that has a better prognosis

Question 9

What is the treatment for a chronic subdural hematoma?

Answer 9

surgical evacuation if large and symptomatic but it may resolve on its own if small and clinically minimal

Question 10

What is the treatment for a acute subdural hematoma?

Answer 10

surgical evacuation unless so small that the clinical implications are trivial

Question 11

rupture of middle meningeal artery?

Answer 11

epidural hematoma

Question 12

biconvex (lentiform) hyperdense blood collection on MRI

Answer 12

Epidural hematoma

Question 13

lucid interval

Answer 13

epidural hematoma

Question 14

Risk of transtentorial herniation?

Answer 14

epidural hematoma

Question 15

risk of CNIII palsy?

Answer 15

epidural hematoma

Question 16

Temporal bone fracture

Answer 16

epidural hematoma

Question 17

treatment for epidural hematoma?

Answer 17

surgical evacuation

Question 18

Etiology of intracerebral hemorrhage?

Answer 18

usually due to hypertension

Question 19

What is the onset of a intracerebral hemorrhage?

Answer 19

acute

Question 20

physical findings of someone with intracerebral hemorrhage?

Answer 20

FOCAL neurological deficits depending on where it is affected

Question 21

treatment of intracerebral hemorrhage?

Answer 21

supportive; monitoring, head elevation, and bed rest

Question 22

physical findings of a spinal cord injury

Answer 22

UMN, sensory deficits, and sphincter and autonomic changes below the level of the injury

Question 23

temporary loss or depression of spinal reflex activity that occurs below a complete or incomplete spinal cord injury

Answer 23

spinal shock

Question 24

can mimic a complete CORD lesion

Answer 24

spinal shock

Question 25

What is the difference between an acute spinal shock injury and GBS?

Answer 25

GBS starts with tingling and loss of sensation in the extremities while spinal shock mimics a complete spinal cord lesion that causes paralysis

Question 26

What is the best imaging for spinal cord injury?

Answer 26

MRI

Question 27

risk associated with lumbar puncture?

Answer 27

epidural hematoma of the spinal cord

Question 28

What causes epidural hematoma of the spinal cord?

Answer 28

fall or direct trauma

Question 29

treatment of epidural hematoma?

Answer 29

surgical

Question 30

sensory disturbance of the perineum

Answer 30

cauda equina syndrome

Question 31

What has sphincter dysfunction

Answer 31

cauda equina syndrome, and myelopathy

Question 32

best diagnostic feature for cauda equina syndrome?

Answer 32

MRI

Question 33

Trauma to the lumbosacral spine below the level of L2

Answer 33

cauda equina syndrome