W19-L11: Traumatic head and spinal cord injury Flashcards Preview

Matt's Block 06 - Neuro block > W19-L11: Traumatic head and spinal cord injury > Flashcards

Flashcards in W19-L11: Traumatic head and spinal cord injury Deck (26):
1

Direct effects of trauma can be seen in

SCALP – lacerations

SKULL – fractures

MENINGES - vascular injury, lacerations

BRAIN/CORD - contusions, lacerations, diffuse axonal injury (DAI) , diffuse vascular injury

2

T/F :Central nervous system (CNS) injury is the leading cause of death in people < 45 years of age in Western countries.

True

3

T/F: CNS injury causes
1% of all deaths
30% of deaths from trauma
50% of deaths due to motor vehicle accidents

True

4

Penetrating injury

direct disruption of tissue

5

Closed injury

movement and compression of neural and vascular structures within bony confines

6

Secondary effects of traumatic injury

Ischaemia
Hypoxia
Cerebral swelling (raised ICP)
Infection
Epilepsy

7

Features of Skull fractures, types and where they occur

Tend to radiate from point of impact, can be depressed, can be open, closed, comminuted (splintering) and can be basal

8

Coup and contrecoup

Coup: at impact site
Contrecoup: Occur when head is not immobilised at the time of injury and involves the opposite side of the brain

9

Where does the sterotypic contusion occur and what is it called?

Base of brain known as basal contusions

10

Healed cerebral contusions

Brain contusions occur at the tips of gyri, and the gyri and sulci become more pronounced as lost tissue is not replaced

11

Lacerations

Penetration by foreign body or skull fragments

12

Missile injuries

Kinetic energy imparted by a bullet is determined by the projectile velocity

13

Vulnerable site of tearing due to sufficient energy transfer

Ponto-medullary junction

14

Diffuse forms of brain injury

Diffuse axonal injury, diffuse vascular injury

15

Axonal swellings

Build up of axonal material that is being transported down the axon (not immediate)

16

Long term effects of diffuse axonal injury

Increased ventricular size, thinned corpus callosum

17

Cord-compressive acute traumatic injury

cord tissue is squeezed both proximally and distally by impaction "toothpase effect"

18

Hydrocephalus

dilated ventricles compresses brain tissue eg blockage of drainage from fourth ventricle

19

Chronic traumatic encephalopathy

-Brain atrophy due to neuronal loss.
-Abnormal deposition of Tau protein.
-Often diffuse deposition of A-beta plaques in cortex

20

Initial response to an expanding brain lesion

expulsion of as much CSF and venous blood as possible. After that, intracranial pressure starts to rise.

21

Where do Herniations of brain tissue occur?

Through Dural openings

22

Two subtypes of cerebral oedema

VASOGENIC – due to blood-brain barrier disruption with increased vascular permeability, mainly involves white matter

CYTOTOXIC – increased INTRAcellular fluid secondary to neuronal, glial or endothelial cell membrane injury. Grey and white matter. Nastier than vasogenic

23

Duret haemorrhages

vessels are fixed so diencephalic herniation causes tearing of these vessels causes brainstem haemorrhages

24

Subfalcine herniation

Cingulate gyrus under falx cerebri

25

Transtentorial herniation

Medial temporal lobe under the tentorium cerebelli

26

Tonsilar Herniation

Cerebellum and brainstem through foramen magnum

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