L3: Head Trauma

Question 2

Types (Mechanisms) of Head Injury

Answer 2

Question 3

Pathology of Concussion

Answer 3

• Transient alteration of consciousness without structural damage.
• Transient disturbance in neuronal function.

Question 4

Symptoms of Concussion

Answer 4

Headache, Nausea, Confusion, Memory loss…

Question 5

Investigations for Concussion

Answer 5

No abnormalities in radiology.

Question 6

Cortical Contusion & laceration in CT

Answer 6

Traumatic brain injury with CT findings.
* Hemorrhagic hyperdense
* Non hemorrhagic hypodense

Question 7

Mechanism of Cortical Contusion & laceration

Answer 7

Coup & contre-coup (counter blow).

Question 8

Site of Cortical Contusion & laceration

Answer 8

Usually frontal and temporal

Question 9

Extradural Hematoma

• Site

Answer 9

Collation of blood between dura & skull.

Question 10

Bleeding Source in Extradural Hematoma

Answer 10

• Middle meningeal artery (90% - The most common).
• Dural venous sinus.
• Bone sinusoid.

Question 11

CP of Extradural Hematoma

Answer 11

3 phases
* Stage of concussion
* Lucid interval
* Stage of brain compression

Question 12

Investigations in Extradural Hematoma

Answer 12

Biconvex in CT

Question 13

TTT of Extradural Hematoma

Answer 13

• Evacuation is life-saving (Osteoplastic craniotomy flap).
• Source of bleeding should be controlled.

Question 14

Def of Subdural hematoma

Answer 14

Collection of blood in the subdural space (between Dura matter & arachnoid).

Question 15

Compare between acute & Chronic Subdural hematoma

• Time
• Causes
• Symptoms
• Investigations
• TTT

Answer 15

Question 16

What are other Intracranial Hemorrhages?

Answer 16

Question 17

Pathology of Brain Edema

Answer 17

• Accumulation of fluid beneath brain tissue
• Common finding after head trauma

Question 18

Types of Brain Edema

Answer 18

A) Vasodilatation → Extracellular
B) Cytotoxic → Intracellular

Question 19

Complications of Brain Edema

Answer 19

• Lead to cerebral swelling and mass effect
• Increased intracranial pressure (N < 10-15)

Question 20

Cerebral perfusion Pressure

Answer 20

Question 21

Brain Herniation

Answer 21

Question 22

Cushing Triad

Answer 22

• Hypertension
• Bradycardia
• Respiratory irregularity

Question 23

Mechanism of Cerebral Ischemia

Question 24

Management of increased ICT

Answer 24

Question 25

Types of Skull Fracture

Answer 25

Question 26

Pathology of **Fissure Fracture**

Answer 26

* Usually heals spontaneously * Dangerous if tear Dural artery e.g., MMA

Question 27

DDx of **Fissure Fracture**

Answer 27

1. Sutures 2. Vascular marks

Question 28

TTT of **Fissure Fracture**

Answer 28

- No Surgical treatment is required. - But close observation to rarely detect EDH.

Question 29

Types of **Depressed Fracture**

Answer 29

Simple & Compound

Question 30

Characters of **Simple Depressed Fracture**

Answer 30

- Simple = closed (Scalp intact) - Green stick fracture - Ping-Pong - High Plasticity of skull bone (Monopole skull)

Question 31

Age in **Simple Depressed Fracture**

Answer 31

Usually in newborn or infant «‹ 1 Y ???

Question 32

TTT of **Simple Depressed Fracture**

Answer 32

Usually non-operative management

Question 33

Pathology in **Compound Depressed Fracture**

Answer 33

- Scalp wound over fracture communicate fracture to atmosphere. - Implantation of hair and bacterial flora high risk of infection

Question 34

Complications of **Compound Depressed Fracture**

Answer 34

Seizures Brain abscess Neurological Deficit

Question 35

TTT of **Compound Depressed Fracture**

Answer 35

Elevation with good disinfection and repair of dura **Any delay in time of surgery → Increased infection rate.**

Question 36

Symptoms of **Anterior Fossa Base Fracture**

Answer 36

Question 37

Symptoms of **Middle Fossa Base Fracture**

Answer 37

Question 38

Assessment of head injury

Answer 38

Question 39

Glascow Coma Scale Aspects

Answer 39

Question 40

Glascow Coma Scale - Eye Opening

Answer 40

Question 41

Glascow Coma Scale - Verbal response

Answer 41

Question 42

Glascow Coma Scale - Motor response

Answer 42

Question 43

Grades of Head Trauma

Answer 43