Pathology of head injury Flashcards Preview

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Flashcards in Pathology of head injury Deck (22)
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1
Q

what is the difference between primary and secondary insult?

A

primary insult is focal trauma to the brain
secondary insult is trauma to the head due to falling over etc from hypoglycaemia, hypotension, hypoxia, infection, haematoma

2
Q

what is the GCS scores that would indicate;

  1. mild injury?
  2. moderate injury?
  3. severe injury?
A
1 = 13-15
2 = 9-12
3 = 3-8
3
Q

how is a patients the glasgow coma scale assessed?

A
eyes opening (out of 4)
verbal response (out of 5)
motor response (out of 6)
4
Q

what is the name of a fracture - caused by blunt trauma to the back of the head which causes fracturing of the orbital bone?

A

contrecoup fracture

5
Q

what is a ring fracture?

A

a fracture forming a ring around the formanen magnum
usually caused by falling from a high height and landing on the feet
causes cervical spine and base of skull to be forced together

6
Q

what is the term for a fracture causeing a fregmented skull?

A

comminuted (mosaic)

7
Q

what is the name for a fracture which is caused y focal impact which causes bone fragments to be pushed in damaging the meninges?

A

decompressed fracture

8
Q

what fracture is commonly tempero-parietal and may continue to the base of the skull (hinge fracture)?

A

linear fracture

9
Q

what is the consequence of intracranial haemorrhage?

A

raised intracranial pressure causing compression of the brain

10
Q

what is the difference in the source of extradural haemorrhage and subdural haemorrahge?

A

extra dural - arteries

subdural - veins

11
Q

what is the cause of sub dural haemorrhages?

A

high impact force which causes straining of the bridging veins

12
Q

why is it hard for clinicians to identify an intracranial haemorrhage?

A

lucid interval
patients may appear fine for a while and the blood will slowly accumulate resulting in death
it should always be considered in head trauma

13
Q

in what type of intracranial haemorrhage is there likely to be a longer lucid interval and why?

A

sub dural haemorrhage because it is due to the rupture of the bridging veins
veins are under less pressure than arteries so will bleed more slowly

14
Q

what is the main consequence of cerebral oedema?

A

coning

15
Q

what is the clinical term for bleeding?

A

contusion

16
Q

hat is the difference between coup contusion and contra-coup contusion?

A

coup contusion = bruising of the brain at the area of impact/injury
contra-coup is bleeding of the brain in the opposite side of where there was impact/force.
i.e. a hit to the front of the head causing bleeding in the back of the skull

17
Q

what can serious rotation forces applied to the brain cause?

A

traumatic diffuse axonal injury

18
Q

what is a lesser degree of diffuse axonal injury?

A

concussion

19
Q

What are the consequences of head injury?

A
Increased ICP due to oedema which can lead to coning = death 
Permanent physical disability 
Post trauma epilepsy 
Punch drunk syndrome 
Psychiatric illness i.e. dementia, PTSD
Chronic sub dural haemorrhage 
Intracranial infection
20
Q

How does diffuse axonal injury occur?

A

High impact force causing the brain the accelerate forwards and backwards which cause tearing of the axons

21
Q

What is the main thing you are worried about when someone has sustained diffuse axonal injury?

A

The cerebral oedema - need to decrease ICP

22
Q

What is the prognosis for diffuse axonal injury?

A

Bad because there is no treatment
You can treat the raised ICP but not the axonal injury
Majority of patients die or sustain persistent vegetative state