Traumatic Brain Injury Part 2 Flashcards

(32 cards)

1
Q

Why are concussions not visible through standard imaging techniques?

A

The damage it has on axons are microscopic

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2
Q

What are complications of axonal tearing

A
  • inflammation
  • necrosis
  • disruption in communication between neurons
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3
Q

The damaged axons may contribute to symptoms of concussions such as;

A

-dizziness, nausea, vomiting
- memory and concentration problems
- sensitivity to light
- fatigue

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4
Q

Why is it challenging to distinguish post concussive symptoms from mental health disorders like depression, bipolar, and PTSD?

A

These symptoms can overlap with mental health disorders. Concussions impact cognitive and emotional functioning mimicking symptoms

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5
Q

What are post concussive syndrome symptoms

A
  • headache/dizziness
  • irritability
  • difficulty concentrating
  • sleep disturbances/fatigue
    -sensitivity to light and noise
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6
Q

When does the timeline for post concussive syndrome start, how long do symptoms typically last

A

Starts when symptoms first appear and not when the head injury occurred. Most symptoms resolve within 6-12 months from their onset

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7
Q

What are 5 treatments for concussions and PCS?

A
  • rest and rehabilitation
  • medications
  • cognitive behavioural therapy
  • physical therapy
  • avoiding re injury
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8
Q

What medications migh be used for treatment with concussions and PCS

A
  • analgesia to manage headache
  • antidepressants and anxiolytics
  • sleep aides like melatonin
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9
Q

What is the consequences of increased ICP?

A
  • brain tissue compressions (vessels and nerves)
  • reduced blood flow leading to ischemia and hypoxia in the brain
  • herniation of the brain
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10
Q

What are ways to manage increased intercranial pressure?

A
  • draining CSF through a craniotomy
  • medications to reduce welling such as mannitol
  • hypertonic saline to decrease ICP
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11
Q

What is Space occupying lesions?

A

Anything that occupies space and increases pressure in the cranial vault

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12
Q

The dura mater contains the Dural sinuses. What is the dural sinuses function?

A

A space that drains blood from the brain back to the venous system

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13
Q

What is the function of the Pia matter

A

To contain the CSF keeping it from leaking into the brain tissue

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14
Q

Beneath the temporal bone lies this artery which is often ruptured in cases of epidural hematoma

A

The middle meningeal artery

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15
Q

Why is nausea and vomiting a common symptom for increased ICP?

A

Because the pressure is irritating the medullary centre of the brain (vomiting centre)

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16
Q

What happens when the herniation centres in the medulla oblongata are irritated?

A

It can affect various cranial nerves particularly the vagus nerve.

17
Q

What does the vagus nerve influence?

A

The nerve extends through the foremen magnum and influences the PSNS function of the body including the GI system. Irritation can lead to projectile vomiting due to PSNS response

18
Q

Where does hemipligia often occur?

A

Contra-lateral to the bleed

19
Q

Where would pupil dilation occur?

A

Ipsilateral to the bleed

20
Q

What is normal ICP (in mmHg)

21
Q

What is cerebral perfusion pressure? (CPP)

A

The amount of pressure needed to ensure that blood can adequately perfume the brain

22
Q

How is CPP calculated

23
Q

What happens to cerebral perfusion as ICP increases

A

Cerebral perfusion becomes more difficult

24
Q

In order to have adequate CPP. The MAP must be ______ than ICP for perfusion

A

MAP must be greater than ICP

25
What would happen if there is a significant drop in CPP?
It can lead to brain ischemia
26
What is typical MAP for an adult?
70-100 mmHg
27
How might the body compensate for an increased ICP
- systemic vasoconstriction through alpha 1 adrenergic activation (increasing BP,Increasing MAP) - widened pulse pressure (systolic pressure significantly higher than diastolic)
28
As ICP increases, ischemia occurs. What is the ischemic casscade that happens
Ischemia - hypoxia - cell damage - Na/k+ pump fails - cell swelling - further increase to ICP - necrosis
29
For every 5 mmHg increase in ICP, the body will try to increase MAP by how much to maintain perfusion?
5mmHg
30
Cushings triad is an indicator of increase ICP. What is this triad?
- hypertension (widening pulse pressure) - Brady cardia - respiratory irregularity (Cheyenne stokes breathing)
31
Why is bradycardia present during an increase in ICP
Because the Systolic pressure is high, the baroreceptors in the carotid body and aortic arch trigger the vagus nerve which causes bradycardia
32
Why do Cheyenne stokes respirations occur in cases with increased ICP
As ICP raises, pressure it put on the brain stem, particularly the medulla oblongata which controls respiratory function