19.11 Path: Traumatic head and spinal injury Flashcards
What describes concussion?
What is it due to?
An instantaneous LOC, temporary respiratory arrest and loss of reflexes
Due to a sudden change in the momentum of the head
What is the leading cause of death in people
CNS injury
What does comminuted mean?
Splintering of bone
What can blood/CSF from nose and/or ears be a result of?
Basal fractures
What can cause an extradural haematoma?
What can cause a subdural haematoma?
Rupture of the middle meningeal artery
Subdural vein (acute or chronic)
What is a contusion? Where do they tend to occur?
Haemorrhagic necrosis (bruise)
At the base of the brain
What is a coup? Contracoup?
Coup: injury at impact site
Contracoup: often when head isn’t mobilised, involves opposite side of brain
What can cause a diffuse axonal injury? What are the long term effects?
Mechanical/shearing injury
Enlarged ventricles, damage of white matter, gliosis
What is chronic traumatic encephalopathy due to?
What then occurs long term? (3)
Due to repeated head injuries
Neuronal loss-brain atrophy
Tau deposition
Diffuse A-B plaques
What are the crainal contents? How much of the liquids?
Brain, CSF (150mL), blood (150mL)
What is the initial response to an expanding brain lesion?
Expulsion of as much CSF/venous blood as possible, then ICP rises
What happens once ICP approaches arterial pressure?
Brain perfusion ceases
What are the two main types of cerebral oedema?
What ‘matter’ do they involve?
What are they due to?
Vasogenic:
Mostly white matter
Due to BBB disruption (increased vascular permeability)
Cytotoxic:
Grey and white matter
Increased intracellular fluid (due to injury)
… not steroid responsive
What can herniate transtentorially?
What about transforaminally?
Medial temporal lobe
Cerebellar tonsil
