Pathology of Head Injury Flashcards Preview

Systems: Neurology AB > Pathology of Head Injury > Flashcards

Flashcards in Pathology of Head Injury Deck (53)
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1
Q

Why does any increase in volume within the skull lead to an increase in pressure?

A

The skull is not expandable

2
Q

Define injury.

A

Injury is a transfer of energy to the body

3
Q

How does velocity affect injury?

A

Increasing velocity will increase the impact and therefore the injury

4
Q

What is a bruise?

A

Damage of little blood vessels resulting in leakage into the subcutaneous tissue

5
Q

What are bruises the result of?

A

Blunt force trauma

6
Q

Describe the formation of peri-orbital bruising.

A
  • Blood will track through the looser tissues and the planes through which it can move
  • Can be a result of a direct blow
7
Q

What are bilateral black eyes usually caused by?

A

Usually a head injury or at the base of the skull. This is due to tracking of blood

8
Q

What is an abrasion/graze?

A

-Injury to the superficial part of the skin caused by friction

9
Q

How do abrasions usually heal?

A

Without scarring

10
Q

What is a laceration?

A
  • Tear or split in the skin due to the application of energy

- It is not a true cut

11
Q

What is the cause of a laceration?

A

Blunt force injury

12
Q

What must you do when treating lacerations?

A

-Explore for damage and foreign bodies

13
Q

How do lacerations occur?

A

Skin splits at the weakest point and causes damage to surrounding tissue

14
Q

What is an incision?

A
  • Sharp force wound caused by cutting when energy is delivered over a very small area
  • It is a true cut
15
Q

How are incisions treated?

A

Easily stitched as they do not cause damage to the surrounding area

16
Q

Give examples of types of injuries.

A
  • Thermal injuries
  • Incisions
  • Lacerations
  • Abrasions
  • Bruises
17
Q

Give examples of types of skull fractures.

A
  • Ring fracture
  • Fissure fracture
  • Depressed fracture
  • Hairline fracture
18
Q

What is a ring fracture?

A

-The skull is a sphere and therefore fractures continue in a spherical fashion

19
Q

What structure is often involved in a ring fracture?

A
  • Foramen magnum

- Diastasis of sutures if sufficient energy

20
Q

What parts of the skull are more susceptible to ring fractures?

A

Petrous temporal bones meeting the flood of the skull which may result in a basal fracture

21
Q

What is a fissure fracture?

A
  • Dissipated energy

- Not enough energy to complete a full ring

22
Q

What are fissure fractures usually the result of?

A

Blunt force trauma

23
Q

What does a depressed fracture indicate?

A

Indicates a little piece of bone has been pushed inwards by the application of energy

24
Q

What is indicative of the weapon used in a depressed skull fracture?

A

Shape and size of fracture

25
Q

What can depressed skull fractures result in?

A

Post-traumatic epilepsy

26
Q

What is a hairline fracture?

A

Barely noticeable fracture that usually does not require treatment

27
Q

What can hairline fractures lead to?

A

Infection if involves structures such as the nose or ear

28
Q

When can hairline fractures become complicated?

A

When they impinge on other structures

29
Q

What structure is closely applied to the skull?

A

Dura mater

30
Q

What retains the configuration of the brain?

A

Pia mater

31
Q

What is the extradural space?

A

Extradural space is a potential space and requires the dura to be stripped from the skull

32
Q

What is an extradural haemorrhage?

A

Blood accumulating between skull and dura

33
Q

What causes extradural haemorrhages?

A

Bleeding meningeal arteries

34
Q

What are extradural haemorrhages usually associated with?

A

Skull fractures that traverse arteries

35
Q

What is a subdural haemorrhage?

A

Bleeding between the dura and arachnoid mater

36
Q

What do subdural haemorrhages occur as a result of?

A

-Occur as the brain moves in relation to the dura. The skull stops moving when it comes into contact with a stationary surface but the brain keeps moving. The emissary veins become stretch and burst. This results in an increase of pressure

37
Q

What type of injury is a subdural haemorrhage?

A

Acceleration/ deceleration injury

38
Q

Who are more susceptible to subdural haemorrhages?

A

-Alcoholics and the elderly are more susceptible due to brain shrinkage

39
Q

What traumatic event can subdural haemorrhages occur in in infants?

A

Shaken baby syndrome

-The chin impacts the chest but the brain continues accelerating

40
Q

What are subdural haemorrhages not usually associated with?

A

Skull fractures

41
Q

What is a subarachnoid haemorrhage?

A

Bleeding between the arachnoid and pia mater

42
Q

What are spontaneous subarachnoid haemorrhages usually due to?

A

Ruptured berry aneurysm

43
Q

What are traumatic subarachnoid haemorrhages usually the result of?

A

Traumatic is usually due to sudden movements of the head with acceleration and rotatory components

44
Q

How can a strike to the chin/neck result in a subarachnoid haemorrhage?

A
  • Can be caused by strike to the neck or near the chin which causes the head to extend backwards
  • In the extra vertebral course of the vertebral artery, there can be damage and dissection which can track up.
45
Q

What are the 2 types of cortical contusions?

A
  • Coup

- Contrecoup

46
Q

What is a coup cortical contusion?

A

Where the direct blow occurs there will be a contusion

47
Q

What is a contrecoup cortical contusion?

A
  • Further contusion diametrically opposite where the force strikes
  • May be larger than the coup injury
48
Q

What natural disease can result in an intracerebral haemorrhage?

A

-Hypertension
-AV anomaly
-Amyloid angiopathy (makes vessels very delicate)
Vascular tumours

49
Q

How can trauma cause intracerebral haemorrhage?

A

Sufficient energy delivered to the brain may result in a deep contusion which can destroy vessels and vulnerable vessel

50
Q

When do diffuse axonal injuries occur?

A

Occurs where there is a large acceleration force on the brain with rotation

51
Q

What is the usual prognosis of diffuse axonal injuries?

A
  • Usually fatal
  • Death may be instantaneous
  • Some will be declared brain dead at hospital
52
Q

What may be considered a very minor form of diffuse axonal injury?

A

Concussion

53
Q

What are diffuse axonal injuries?

A

Glide haemorrhages in the corpus callosum