2.16 Intracranial Herniation and Brain Contusion Flashcards
What is a concussion?
-Concussion is defined as “a clinical syndrome due to mechanical, usually traumatic, forces characterized by immediate and transient impairment of neural function, such as alteration of consciousness, or disturbance of vision and equilibrium”. -Usually last for less than six hours
What is a contusion?
-Severe, causing bruising, or tearing of the underlying cortex and white matter (contusions) with more severe signs, and symptoms, possibly with complications leading to coma and death.
What is a cerebral contusion?
•A bruise of the cortical surface of the brain as a result of head trauma
What causes a cerebral contusion?
The result of energetic anteroposterior displacement, when a moving head strikes a fixed object.
What is a Coup contusion?
-When the cerebral contusion occurs at a point of impact
What is a Contracoup contusions?
-The occipital area strikes the ground in a backward fall, the resulting abrasions are prone to occur on the contralateral side of the brain opposite the point of contact, i.e. in the frontal or temporal cortex.
What are the three types of brain herniations?
- Subfalcine herniation
- Tonsillar herniations
- Transtentorial herniations
What is a subfalcine herniations?
- Asymmetrical expansion of the cerebral hemisphere displaces the cingulate gyrus under the falx.
- Causing compression of branches of the ant. cerebral artery.
What is tonsillar herniations?
-Displacement of the cerebellar tonsils through the Foramen magnum
What can tonsillar herniations cause?
Causes compression of cardiac and respiratory centers, leading to death. (called “Coning”)
What is a Transtentorial herniations?
-Occurs when the medial aspects of the temporal lobe (hippocampus) is compressed against the free margin of the tentorium cerebelli.
What does a transtentrotial herniation cause?
-Displacement causes compression of the 3rd cranial nerve with fixed pupillary dilation and impairment of ocular movements on the side of the lesion.
What is a Duret Hemorrhage?
Progression of transtentorial herniation is often accompanied by irreversible necrotic and hemorrhagic lesions in the midbrain and pons.
What does a Duret Hemorrhage look like?
Linear or flamed-shaped lesions that usually occur in the midline of the B. stem.
What is the Falx Cerebri?
Is a double-fold of dura mater that descends through the interhemispheric fissure in the midline of the brain to separate the cerebral hemispheres.
