Trauma of the CNS Flashcards Preview

Brain and Behavior Part 2 > Trauma of the CNS > Flashcards

Flashcards in Trauma of the CNS Deck (29):
1

anatomy of skull to brain (list layers)

scalp
periosteum of outer table
inner table (fused to outer table)
potential epidural space
dura mater
potential subdural space
arachnoid
subarachnoid space (contains blood vessels and CSF)
pia mater
brain

2

general rules for trauma

1) extent of external lesion is not reliable indicator of deeper lesions
2) lethal lesions of skull/brain may be small or absent

3

where can soft tissue injuries occur

may be external on face or scalp
or
maybe internal - subepithelial, galeal or periosteal

4

what are the 5 kinds of fractures that occur in skull?

linear
compound
complex
depressed
contrecoup

5

what is a linear fracture?

secondary to contact with large flat object - fracture begins along inner table--> usually not lethal

6

what is a compound fracture?

fx associated with scalp laceration

7

what is complex fracture?

fx involving multiple bones

8

what is depressed fracture?

secondary to contact with small objects

9

what is contrecoup fracture>?

located distant from point of injury

10

what typically causes a hinge fracture?

auto accident - it is gaping fracture extending across entire base

11

>what are the two types of dural hematomas? How are they different?

epidural - b/w skull and dura & arterial bleeding
subdural - below dura & venous bleeding

12

how does brain change in response to epidural hematoma?

compression! Caused by epidural blood - accurate rapid dx for immediate evacuation is mandatory to ensure survival

13

which is more serious epidural or subdural hematoma?

epidural

14

describe the pathogenesis of SDH

caused by motion of brain with respect to skull and dura tearing bridging veins
typically located over cerebral convexities
increased risk in people w/ brain atrophy
tears of veins more likely with rapid acceleration/deceleration

15

what is the most common traumatic lesion of brain?

contusion/laceration
often associated with brain swelling

16

what are the types of contusions/lacerations? (3)

1) fracture C/l - at site of fracture and tend to be severe
2) coup contusion - caused by bending/rebounding of skull at site of injury w/ or w/o fracture
-moving object striks stationary but movable head
3) contre coup contusion - located distant, usually opposite point of impact

17

what are the two mechanism of contre coup contusions?

1) impact - moving head strikes fixed object
2) impulsive loading- head set in motion or moving head is stopped without being struck or impacted

18

where are contre coup contusions most common?

orbito-frontal surfaces & temporal bones - where brain contacts skull

19

do contusions cause seizures?

yes

20

what typically causes closed head injuries?

severe angular acceleration forces
most common in pedestrian-bike-vehicular impracts, helmeted cyclists, shaken babies

21

what are 3 types of diffuse brain injury?

diffuse axonal
concussion
brain swelling

22

what is typical distribution of lesions secondary to angular acceleration?

parasagittal white matter
corpus collosum
septum pellicudum/fornix
deep grey
superior cereballar peduncle

23

what are retraction balls?

hallmark of diffuse axonal injury - swelling in axons due to build up of transport materials b/c cytoskeleton is damaged

24

describe pathophys effects of severe concussion

hallmark of diffuse axonal injury - swelling in axons due to build up of transport materials b/c cytoskeleton is damaged
elevated ca2+ --> neuronal cell death
elevated lactic acid

25

what can cause ischemic brain damage?

concussion (causes swelling)
hypotension-cardiac arrest
status epilepticus

26

what occurs after transection of brainstem secondary to hyperextension?

death instantaneously

27

basic stats about abusive CNS trauma in infants/children

65% of abused I/C die of CNS trauma

28

how common is SDH in shaken infants?

80 - 90% of infants who are shaken have SDH --> usually not deadly

29

what are common injuries of shaken babies?

SDH
transection of corpus collosum
gliding contusion
transection of spinal cord
optic nerve sheath hemorrhages
black brain