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MBB Block III > Trauma > Flashcards

Flashcards in Trauma Deck (14)
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1
Q

coup contusion

A

beneath blunt head trauma
usually in frontal lobes or in temporal lobes. In occipital and cerebellum, usually a sign of skull fracture.
see hemorrhage

2
Q

Contrecoup contusions

A

no impact during acceleration. contusion produced by tensile strains. often not localized behind contusions.

3
Q

Contusion vs. laceration

A

contusion: extravasation of blood in the context of tissue integrity
laceration: detachment or loss of tissue

4
Q

gliding contusion

A

frontal, temporal lobes
often multiple
due to rupture of intrinsic cerebral vessels
aka intracerebral hematoma

5
Q

What is involved in cortical contusions/lacerations?

A

conical or wedge shaped. involve the crests of the gyri.

6
Q

epidural hematoma. epidemiology. etiology. comorbidities. clinical presentation/characteristics

A

fall or traffic accident
rare in infants
usually middle meningeal artery tears or middle meningeal vein tears. usually associated skull fracture.
many also have subdural hematoma and contusion
usually unilateral
usually have a post-traumatic lucid interval.
EMERGENCY

7
Q

subdural hematoma. associations. types. epidemiology.

A

ruptured dorsal bridging veins (drain cortical veins into superior saggittal sinus) falls, accidents, whiplash, anticoagulant therapy/ amyloid angiopathy.
may be acute, subacure, or chronic. actue has blood, chronic has fluid.

8
Q

acute subdural hematoma

A

20% are bilateral. may be arterial or venous. often dorsal bridging veins. no skull fracture necessary.

9
Q

chronic subdural hematoma

A

wks ot months after head trauma from small rebleeds.
no history of trauma in up to 50%
asociated with coagulation therapy, shunts, epilepsy, ETOH, cortical atrophy. often bilateral.
often in elderly.

10
Q

subarachnoid hemorrhage

A

may be traumatic or atraumatic. if atruamatic, usually from rupture of saccular aneuryasms; some from AVMs or infections.
if traumatic it is secondary to superficial contusions or lacerations of the brain releasing blood in the subarachnoid space.

11
Q

Difuse axonal injury

A

see axonal injury and edema. with silver stains detected by 11 hr. other stains detect within 2 hrs. widespread axonal tearin esp. in white matter.
produced by angula acceleration or deceleration. microglial nodules develop in a few weeks.

12
Q

What is chronic traumatic encephalopathy?

A

repeated concussions, usually due to sports. 17% of ppl with repetitive concussions or midle traumatic brain injury. early causes acute memory loss and probs with conc. confusion , irritability and affective lability.
later causes lack of insight, dementia, parkinsonism, ataxia, and speech abnormalities.

13
Q

chronic traumatic encephalopathy pathogenesis

A
axonal injury.  usually no shearing.
this causes influx of Ca
mitochondrial swelling
changes to microtubules
changes in axonal transport
Tauopathy and neuronal death.
14
Q

Pathology of chronic traumatic encephalopathy

A
cortical atrophy
medial temporal and thalamic atrophy
ventricular dilation
tau neurofibrillary tangles
astrocyctic tangles