Neuro- Class 2 - Trauma and injury Flashcards
Signs and symptoms of subdural hematoma?
– tenderness over hematoma – progressing dementia, generalized rigidity,
What is a transactions injury?
severing of spinal cord – most common when we think of spinal cord injury – total loss of function below injury – spinal coloum cut – not coming back
What can we see after the initial spinal shock injury is done?
We know that we lose everything due to spinal shock, but when the reflexes return then we can see the damage caused by the initial injury – similar to when secondary injury recovers – we may see some return of function
What kind of complication are post- traumatic seizures?
2-16% highest risk in open brain injuries – will develop seizures – start within days can last up to 2-5 years – not well understood, we do prophylactic treatments – use anti-seizure medications to prevent potential – can be short or long – not being diagnosed with epilepsy as we are expecting this to go away
Patho for autonomic dysreflexia?
1.) Noxious stimulus major SNS response: vasoconstriction
2.) Vasoconstriction below the injury causes increased blood volume above the injury
3.) Hypertension above the injury. Triggers parasympathetic response bradycardia and vasodilation
What happens over time with secondary spinal cord injuries?
– over time the tissue is replaced with collagenous tissue so within three to four weeks can have return of some function.
What can happen if autonomic dysreflexia goes untreated?
If left untreated – think about what is above the injury getting increased blood flow – below is not getting enough – seizures, pulmonary edema, renal insufficiency, MI, can cause cerebral edema can lead to brain injury or death
what is the patho behind the systemic and cerebral effects of a secondary brain injury?
First insult – inflammation – cerebral edema – increase intracranial pressure – compromises blood vessels -decreases cerebral blood flow – cerebral hypoxia & ischemia –
second insult which starts the circle over – ends up spiralling downwards
What is a TBI?
TBI – acquired injury – not born with
What is an aneurysm?
Spontaneous leakage of blood into brain tissue – in traumatic brain injury may have several intracerebral hematomas at the same time
What is autonomic dysreflexia?
noxious stimulus causes an exaggerated SNS response – causes vasoconstriction below injury – increased blood flow above injury
Primary Vs secondary brain injury?
Primary vs secondary – length of time is considered
Primary – immediate up to a few minutes to fully develop –
then we move into secondary injury phase – can start in minutes but can continue for days
What happens to supporting ligaments in spinal cord and vertebral injuries?
supporting ligaments are torn from spine – spine moves out of alignment – flection or extension or flexion rotation injury that results in dislocation
What is a blast primary brain trauma?
Brain injury caused by vibration through the brain
What is neurogenic shock?
Absence of sympathetic activity – parasympathetic is unopposed – vasodilation, Hypotension, bradycardia, poiklethermia
general signs and symptoms of Brian trauma?
loss of consciousness, other symptoms dependent on location
Severe diffuse axonal injury?
involving both hemisphere and brainstem – comatose state lasts days to months
What is a compressed vertebral fracture?
spine is pushed down on itself – no displacement – no other damage – loss of function or sensation – body will heal it’s self – sent home
Signs and symptoms of contusions?
S&S loss of consciousness, reflexes, may fall because of trauma
What is a focal injury brain trauma?
*It is a primary brain trauma
Focal injury – observable precise location – hit in the forehead or back of head – we can see where it was hit
What kind of spinal cord injury is a contusion/concussion?
– contusion or concussion similar to brain – results in temporary loss of function – bruising within neural tissue –
differentiate bleeding of neural tissue and bleeding into the neural tissue (hemorrhagic condition)
Brain trauma is defined as?
alteration of brain function caused by an external force
What is there a loss of in spinal shock?
complete loss of reflex, flaccid paralysis, loss of sensation, bowel and bladder control – may experience HTN poor venous circulation, hypothalamus can’t regulate temperature
Where on the spinal cord does autonomic dysreflexia occur?
someone with a spinal cord injury T6 or higher
Mild diffuse axonal injury?
decerebrate or decorticate posturing, prolonged stupor or restlessness
Ex of a primary brain trauma?
Something has come in contact with the brain:
1.) the head is hitting something like a wall or the ground
2.) the head is being hit with something like a bat
3.) shock waves are hitting the head – military trauma
Signs and symptoms of autonomic dysreflexia?
What is the hall mark symptom?
anxiety – bowel or bladder issues – blurry vision, dizzy, lightheaded, fever, diaphoretic above point of injury – all of this is happening in upper body –
profound hypertension – hall mark of autonomic dysreflex
Systemic Manifestations of a secondary brain injury?
Systemic - stroke, hypotension, anemia, hypoxia , hyper- or hypo- capnea
What area of the brain are contusions most common with? What does this control?
Majority contusions in frontal lobe, which controls our emotional, judgement, speaking, volunteer movements (review if needed what each area of the brain controls)
What are Patients with a primary injury are monitored for?
Patients with a primary injury are monitored for several days for secondary injury development
