17.5 Trauma

Question 1

Epidural Hematoma

Answer 1

Collection of blood between the dura and the skull due to rupture of the middle meningeal artery

Question 2

What artery is often ruptured in epidural hematoma?

Answer 2

Due to rupture of the middle meningeal artery - often with fracture of the temporal bone

Question 3

What will be seen on CT of an epidural hematoma?

Answer 3

Lens-shaped lesion

Question 4

What is the feared complication of epidural hematoma?

Answer 4

Herniation - can be lethal

Question 5

Subdural Hematoma

Answer 5

Collection of blood beneath the dura

Question 6

What is the cause of subdural hematoma?

Answer 6

Tearing of bridging veins between the dura and the arachnoid - usually from trauma

Question 7

What is a feared complication of subdural hematoma?

Answer 7

Herniation

Question 8

Herniation

Answer 8

Displacement of brain tissue due to mass or increased intracranial pressure

Question 9

What are the types of herniation?

Answer 9

• Tonsillar
• Subfalcine
• Uncal

Question 10

Tonsillar Herniation

Answer 10

Cerebellar tonsils are pushed through the foramen magnum and compresses the brain stem

Question 11

Subfalcine Herniation

Answer 11

Cingular gyrus herniates under the fall cerebri which compresses the anterior cerebral artery and lead to infarction

Question 12

Uncal Herniation

Answer 12

Uncus of the temporal lobe herniates into the tentorium cerebellar

Question 13

What 3 structures can uncal herniation lead to the compression of?

Answer 13

• CN III (eyes move down and out with dilated pupil)
• Posterior Cerebral Artery (infarction of the occipital lobe)
• Paramedian Artery (hemorrhage of brainstem)