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Flashcards in Neuro #2 Deck (23)
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1
Q

3 types of subdural hematoma

A

Acute: symptomatic within 24 hours (children)
Subacute: symptomatic within 2-10 days
Chronic: symptomatic after 2 weeks (elderly - cerebral atrophy)

2
Q

Epidural Hematoma

A

Bleeding between the skull and the dura mater.

  • usually arterial (middle meningeal artery temporal region)
  • cause Uncal herniation.
  • results in ipsilateral pupil W contra lateral neuro deficits / posturing.
3
Q

Define process that gives Uncal herniation findings.

A

Uncal herniation shifts brain down and away from where herniation is. If on R will shift brain down and to the L. Pinches L optic nerve.

  • optic nerves come off the occipital lobe, supra-tentorial and come down through insecure, cross and connect to eyes.
  • pinched all optic nerve crosses to R eye.
  • R eye dilation w/ L sided neuro deficits.
4
Q

Subdural Hematoma

A

Blood between the dura and arachnoid layers

  • Usually venous in nature
  • high morbidity & mortality
  • can sneak up on you.
  • 3 types
5
Q

Subarachnoid Hemorrhage

A

Bleeding between arachnoid membrane and the Pia Mater
Where CHF is = increases infection potential
Trauma is most common cause
Or Berri Aneurysm (secondary to HTN)

6
Q

Subarachnoid Hemorrhage complaints

A

“worse headache of my life”
N/V, stiff neck, visual disturbances, ALOC
Commonly confused w/ meningitis (lumbar puncture issue)

7
Q

Lumbar puncture considerations with subarachnoid hemorrhage.

A

Contraindicated id subarachnoid bleed is possible.

CSF pressures could tamponade bleed. LP can cause runaway hemorrhage. CT prior to LP

8
Q

Intracerebral Hemorrhage

A

Hemorrhage in brain parenchyma

  • produced by shearing and tensile forces
  • white matter of frontal and temporal regions
  • associated with contusions, subdural hematoma, DAI
  • less common, delayed onset
  • if enters ventricle, bleed will progress quickly.
9
Q

Intraventricular Hemorrhage.

A

Bleeding into the ventricles as a result of severe brain trauma

  • sheering forces
  • high mortality rate
  • usually found in temporal and frontal lobes.
10
Q

Closed head injury: Mild Cuncussion

A

Results from rotational force.
Reversible with no persistent sequelae
Retrograde amnesia of short duration.

11
Q

Closed head injury: Classic Concussion

A

Rotational or direct forces
Reversible with memory and info processing problems
Brief LOC, retrograde and post-traumatic amnesia

12
Q

Closed head injury: Diffuse Axonal Injury (DAI)

A
  • Diffuse shearing injury, rotational acceleration
  • irreversible with profound neuro, psych and personality deficits
  • usually coma, entire brain has taken insult and is swelling. Increased ICP, frequently fatal, survival correlates with long term disability, personality changes.
13
Q

Linear skull fracture

A

A line that extends toward the base of the skull

14
Q

Linear stellate skull fracture

A

Multiple fracture that radiate from the compressed area

15
Q

Diastatic skull fracture

A

Involves a separation of the bones at a suture line or a marked separation of bone fragments.

16
Q

Depressed skull fracture

A

May be closed or open.

17
Q

Basilar skull fracture

A

Fracture of the base of the skull

  • battle signs: bruising behind ear on mastoid bone
  • peri orbital ecchymosis: raccoon eyes, around eyes
  • otorrhea- bleeding from ear w/ CSF Leak
  • Rhinorrhea- bleeding from nose w/ CSF LEAK.
18
Q

Basilar skull fracture Early and late signs

A

Early: otorrhea, Rhinorrhea
Late: Battles and raccoon eyes.

19
Q

Pneumocephalus

A

Air trapped in the skull
Boyles law will cause gas expansion / cerebral compression
Consider with deterioration immediately after ascent.

20
Q

LeFort 1

A

Fx of maxilla

21
Q

Lefort 2

A

Pyramidal fracture along sides of nose

  • causes a pyramid shape
  • separates off top of maxilla
  • nose and top of mouth become free floating segments.
22
Q

Lefort 3

A

Fracture runs through zigomas though zygomatic arches

-entire face from eyes down are free-floating

23
Q

Lefort fractures

  • most common symptom
  • trigeminal nerve considerations
A

Most common symptom: epistaxis

Increased risk of trigeminal nerve injury, resulting in facial sensory overload and clenching of the jaw (trismus)