Head/Brain injury Flashcards
(10 cards)
Which one of the following statements regarding injury-related mortality in South Africa is NOT correct?
a. The annual incidence of road traffic accidents in SA is similar to the global rate.
b. Injury-related mortality is six times higher than the global rate.
c. Pedestrians represent about half of road traffic fatalities in SA.
d. Interpersonal violence is a more frequent cause of injury-related mortality in SA.
Answer: a
The rate of road traffic injuries and fatalities in SA is significantly above global norms.
Which one of the following statements regarding traumatic brain injury (TBI) is NOT correct?
a. Direct impact between a mechanical force and the head is a prerequisite.
b. Concussive forces such as from an explosion may cause significant TBI.
c. Inadequacy of rehabilitation facilities and services adds to the problem in SA.
d. TBI may occur with open or closed head injuries.
Answer: a
Direct mechanical impact is not a prerequisite.
Concussive or blast forces, rapid acceleration - deceleration, and shockwaves from explosions can cause significant brain injury without direct head contact.
Which one of the following statements regarding head injury is NOT correct?
a. Primary injury is induced by a mechanical force and occurs at the moment of injury.
b. Secondary injury is not mechanically induced, may be delayed, and is superimposed on an already affected brain.
c. Brain concussion is reversible.
d. Brain concussion by definition lasts <3 hours.
Answer: d
Concussion is not defined by a strict time limit.
Symptoms of concussion may lasts for hours, days, or even weeks.
Which one of the following statements regarding brain concussion is NOT correct?
a. There is always an alteration of consciousness.
b. The CT scan is usually normal or only shows mild cerebral swelling/oedema.
c. The MRI scan is sensitive and shows changes in >/=50% of cases.
d. Neuro-behavioural changes are common.
Answer: c
Concussion can involve a loss of consciousness - it is NOT a requirement for diagnosis.
(?)
Which of the following statements regarding epidural haematoma is NOT correct?
a. The skull is usually intact.
b. The blood is usually arterial, commonly from the middle meningeal artery.
c. Bleeding is rapid.
d. The brain may herniate through the foramen magnum.
Answer: a
Epidural haematomas are most commonly associated with a SKULL FRACTURE.
Which of the following statements regarding signs of epidural haematoma is NOT correct?
a. Loss of consciousness is unusual.
b. There may be ipsilateral pupillary dilation.
c. There may be development of contralateral paralysis.
d. Manifestations are more the results of increasing inter cranial pressure than of brain tissue injury.
Answer: a
Classic presentation of epidural haematoma involves loss of consciousness.
Stages of clinical presentation of epidural haematoma:
1. Initial brief loss of consciousness at the time of injury.
2. Lucid interval - period of apparent normalcy or recover.
3. Rapid deterioration in consciousness as the haematoma expands and compresses the brain.
Which of the following statements regarding the Glasgow Coma Scale (GCS) is NOT correct?
a. The GCS score is directly proportional to the severity of the injury.
b. Moderate GCS scores in the 9-12 range correlate with loss of consciousness lasting from 1 hour to 1 day.
c. The GCS is simple to administer and assess.
d. Inter-rater reliability of the GCS is excellent.
Answer: b
They are INVERSELY PROPORTIONAL -
* Lower GCS = More severe neurological injury.
* Higher score = Less severe neurological injury.
Which one of the following statements regarding secondary brain injury is NOT correct?
a. Impaired respiratory function may lead to hypercapnoea.
b. Cardiovascular instability may result in low cardiac output.
c. Liberation of excitatory amino acids may aggravate the situation.
d. Hyperoxia is neuroprotective.
Answer: d
Hyperoxia is NOT neuroprotective.
- Hyperoxia = excessively high levels of oxygen in the blood.
- Hyperoxia can be harmful - high levels of oxygen can lead to the formation of reactive oxygen species (free radicals) which cause oxidative stress and further neurological damage.
Which one of the following statements regarding cerebral oedema is NOT correct?
a. The oedema may result in cerebral ischaemia.
b. Cell membranes become impermeable.
c. Cellular ionic pumps fail due to energy depletion.
d. Osmotically active solutes are reabsorbed into cells.
Answer: b
In cerebral oedema cell membranes become MORE permeable or lose their integrity.
- Loss of integrity is due to energy failure, leading to dysfunction of ion pumps = ions and water rush into the cells causing them to swell.
Which one of the following is NOT a manifestation of raised inter-cranial pressure?
a. Vomiting
b. Pupillary contraction
c. Impaired respiratory drive
d. Blood pressure fluctuations
Answer: b
Raised ICP = Pupillary dilation
