Neural Bleeds

Question 1

What does the frontal lobe control?

Answer 1

Executive functions,
Thinking
Planning
Organising
Problem solving
Emotions
Behaviour
Personality

Question 2

What does the parietal lobe control?

Answer 2

Perception
Making sense of the world

Question 3

What does the temporal lobe control?

Answer 3

Memory, understanding , language

Question 4

How many hemispheres does the cerebellum have and what’re is it located?

Answer 4

2 hemispheres
Infra tentorial

Question 5

What is the falx cerebri?

Answer 5

Tough membranous structure - runs down the centre of the skill to provide support to the brain

Question 6

What are the functions of the cerebellum?

Answer 6

Provides smooth, coordinated body movement

Question 7

Where is extra dural?

Answer 7

Between skull and dura

Question 8

In extradural bleeds what is the blood?

Answer 8

Arterial

Question 9

Where is the subdural space?

Answer 9

Between the dura and arachnoid

Question 10

In a sub dural bleed what is the blood?

Answer 10

Venous

Question 11

What is the blood in a subarachnoid bleed?

Answer 11

Arterial

Question 12

What is the Monro-Kellie hypothesis?

Answer 12

The total sum of the volumes of brain, CSF and Intracerebral blood is constant.

Question 13

What are some of the different types of brain herniation?

Answer 13

• central herniation
• intracerebral mass
• cingulate herniation
• uncal herniation
• infratentorial herniation

Question 14

What is the function of the ventricles in the brain?

Answer 14

CSF is produced in the choroid plexus
- produces 400-700 mls a day

Circulation
Protects / acts as a buffer
Removes metabolic waste
Maintains homeostasis

Question 15

Why is acute haemorrhage hyperdense on CT?

Answer 15

Normal blood is 56 HU
Acute haemorrhage / clot has a higher protien concentration due to the high haemoglobin levels so a different HU

Question 16

How do we classify bleeds? - by location? (2)

Answer 16

Intra-axial
Extra- axial

Question 17

What are the subtypes of extra-axial bleeds? (4)

Answer 17

Extra dural
Subdural
Subarachnoid
Intraventricular

(Essentially bleeds outside of the brain matter)

Question 18

What are the subtypes of intra-axial haemorrhage?

Answer 18

Intra-cerebral haemorrhage (inside the brain matter)

• lobar
• Pontine (pons)
• Basal ganglia
• Cerebellar

Question 19

What are extra-dural bleeds?

Answer 19

Lentiform in shape - (aka lemon shape)
Arterial
Traumatic
Associated with skull fracture sites
Does NOT cross suture lines
Most common location - temporal bones

Question 20

What are subdural bleeds?

Answer 20

Venous
Can cross suture lines
Common in either elderly or young (can be associated with NAI), alcoholics, those on anticoagulants and with frequent falls

Crescent or banana shaped

Question 21

What is the injury called when there is a injury to the brain after it has been impacted onto the opposite side to the injury site?

Answer 21

Contrecoup injury = opposite side

Coup = same side

Question 22

What does brain oedema mean? How does it appear on CT and what are some of the common causes?

Answer 22

Abnormal shifts of water across various compartments of the brain parenchyma

Appears dark on CT - dark rings around bleeds

May be due to trauma, stroke, tumour or abscess

Question 23

What areas do Cytotoxic injuries affect?
What are some of the common causes

Answer 23

They affect both white and grey matter

Commonly caused by strokes

Question 24

What areas of the brain does vasogenic injures affect?

Answer 24

Only the white matter is affected - grey matter is usually normal

Commonly caused by tumour or abscess

Question 25

What is a diffuse axonal injury?

Answer 25

• Severe form of TBI due to shearing forces -
  The Brains long connecting nerve fibres (axons) are torn after the brain is shifted and rotated within the skull

Usually diagnosed on MRI

Poor prognosis - sportive care only