Unit 2: TBI and Stroke Flashcards Preview

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Flashcards in Unit 2: TBI and Stroke Deck (45):
1

L1: Which pathologic finding? Concussion with catastrophic cerebral congestion and increased intracranial pressure due to pathologic dysregulation of intracranial vessels

Second Impact Syndrome

2

L1: Which pathologic finding? Downward pressure centrally that causes bilateral uncal herniation

Central herniation

3

L1: Which pathologic finding? Intracraial bleeding resulting from tearing of bridging veins that connect the cortical surface to the sagittal sinus

Subdural Hematoma

4

L1: Which pathologic finding? Protrusion of the cerebellar tonsils down into the foramen magnum, which can produce Cushing's reflex by medullary compression

Tonsillar herniation

5

L1: Which pathologic finding? Uncus crosses the tentorial edge and pushes into the posterior fossa, compressing on midbrain, cerebral peduncle, and ispilateral, oculomotor nerve

Uncal herniation

6

L1:Which pathologic finding? Intracranial bleeding frequently resulting from fractures near the middle meningeal artery

Epidural Hematoma

7

L2: ______ infarcts appear on Diffusion Weighted Imaging (DWI) MRI.

New

8

L2: ______ infarcts appear on FLAIR T2-weighted MRI.

Old

9

L2: Imaging protocol for suspected stroke: _______ > _______ > ________

Noncontrast CT; Perfusion CT; CT angiogram

10

L2: On CT scan, hemorrhagic strokes appear _____ (whiter/darker), or more radio______, than surrounding brain tissue.

whiter; -paque

11

L2: On CT scan, ischemic strokes appear _____ (whiter/darker), or more radio_____, than surrounding brain tissue.

darker; -lucent

12

L2: On MRI, infarcts appear ______.

white

13

L2: On perfusion CT, at-risk tissue shows _____ time to perfusion, ______ time to peak, and ______ blood flow

increased; increased; normal

14

L2: On perfusion CT, completed infarcts show ______ time to perfusion, _______ time to peak, and ______ blood flow

increased; increased; decreased

15

L2: Surgical Treamtment for ischemic strokes

Endarterectomy

16

L2: Treatment for hemorrhagic stroke prevention

Aneurysm clipping or coiling

17

L2: Treatment for ischemic stroke resuscitation

t-PA

18

L2: What is a sign visible on imaging that demonstrates axonal injury has occurred?

Hemorrhage

19

L2: Which pathologic finding? A brief episode of neurologic dysfunction caused by focal brain or retinal ischemia with clinical symptoms typically lasting less than one hour, without evidence of acute infarction

Transient Ischemic Attack (TIA)

20

L2: Which pathologic finding? Arterial media hyptrophy that can result or occlusion or stenosis, commonly in the carotid artery

Fibromuscular Dysplasia

21

L2: Which pathologic finding? Associated with arterial dissection and intracranial saccular aneurysms

Fibromuscular Dysplasia and Moya Moya Disease

22

L2: Which pathologic finding? Can cause a duret hemorrhage in which the ascending reticular activating system is disrupted

Uncal herniation

23

L2: Which pathologic finding? Cingulate gyrus is pushed away by a mass effect and herniates beneath the falx cerebri

Subfalcine herniation

24

L2: Which pathologic finding? Edema resulting from brain swelling due to breakdown of the blood-brain barrier

Vasogenic edema

25

L2: Which pathologic finding? fixed focal neurological deficit attributable to arterial or venous territory, typically lasting longer than 24 hours with evidence of acute infarction

Ischemic Stroke

26

L2: Which pathologic finding? Focal occlusion of the middle cerebral artery due to intimal hyperplasia

Moya Moya Disease

27

L2: Which pathologic finding? Intracranial bleeding resulting from translational acceleration changes

Subdural Hematoma

28

L2: Which pathologic finding? Intracranial bleeding that occurs on the rough bony surface of the anterior fossa or along the edge of the sphenoid greater wing

Subdural Hematoma

29

L2: Which pathologic finding? No gross findings on CT, retraction balls on microscopic analysis

Diffuse Axonal Injury (DAI)

30

L2: Which pathologic finding? Presents following injury with a lucid interval followed by progressive obtundation and coma

Epidural Hematoma

31

L2: Which pathologic finding? Presents with severe short-onset headache with mortality in the majority of patients

Subarachnoid hemorrhage

32

L2: Which pathologic finding? Results from high velocity rotational acceleration injury

Diffuse Axonal Injury (DAI)

33

L2: Which pathologic finding? Stroke most commonly occurring in the basal ganglia, thalamus, pons, or cerebellum

Intracranial hemorrhage

34

L2: Which pathologic finding? Swelling of astrocytes in response to extracellular hyperkalemia and high potassium uptake

Cytotoxic edema

35

L2: Which pathologic finding? Type of stroke most commonly caused by trauma and ruptured aneurysm in atraumatic patients

Subarachnoid hemorrhage

36

L2: Which vascular involvement? Stroke resulting in lower extremity numbness and weakness

Anterior cerebral artery

37

L2: Which vascular involvement? Stroke resulting in upper extremity asymmetric weakness

Middle cerebral artery

38

L2: Which vascular involvement? Stroke with acute onset movement disorders of asymmetric distribution

Small vessels

39

L2: Which vascular involvement? Stroke with coma

Basilar artery

40

L2: Which vascular involvement? Stroke with vision disturbances

Posterior cerebral artery

41

L3: Domains of Scoring in the Glasgow Coma Scale

Eye Opening, Motor Response, Verbal Response

42

L3: Mechanisms of reducing intracranial pressure (3)

osmotic diuretic (mannitol), drain CSF, induce coma (barbiturates)

43

L3: New infarcts appear on ______ MRI.

Diffusion-Weighted Imaging (DWI)

44

L3: Old infarcts appear on ________ MRI.

FLAIR T2-weighted

45

L3: Treatment for ischemic stroke prevention (3)

Aspirin, thienopyridines, anticoagulants