26 Pathology: Trauma and Hydrocephalus

Question 1

Trauma

• Axons
  
  • What is the name of subtle yet widespread injury to axons?
  • What can cause injury to axons, even if no impact on the head occurs?
  • How does this injury relate to coma patients?

Answer 1

Question 2

Epidural Hematomas

• Although these can expand rapidly, they can still take several hours after a traumticafest to produce neurological symptoms. Why?

Answer 2

Question 3

Subdural Hematoma

• What do these hematomas look like?
• Do they extend into the depths of the sulci or do they lie on the surface of the brain?
• What happens to brain tissue under the hematoma?

Answer 3

Question 4

Epidural Hematoma

• What artery is especially vulnerable to this type of injury?
• Ages
  
  • What is the difference between infants vs Adults/children in how this injury occur?

Answer 4

Question 5

Hydrocephalus

• Infants
  
  • What happens if hydrocephalus develops before the cranial sutures close?
• Name 4 potential lesion sites for obstrucutruve hydrocephalus

Answer 5

Question 6

Herniation

• Tonsillar Herniation
  
  • What occurs in this herniation?
  • What is the reason this herniation is often fatal?

Answer 6

Question 7

Subdural Hematoma

• How are subdural organized, relative to 1 week, 2 weeks, and 3 weeks?
• How do you treat them?

Answer 7

Question 8

Hydrocephalus

• Communicating hydrocephalus
  
  • Does the entire ventricle system enlarge?
  • What is it usually due to?

Answer 8

Question 9

Trauma

• What shape do contusions have?
  
  • Where is the widest aspect?

Answer 9

Question 10

Trauma

• What is the difference between a coup and contrecoup injury?
• These are classified as contusions.
  
  • What parts of the brain are more susceptible to contusions?

Answer 10

Question 11

Herniation

• Transtentorial (uncinate) Herniation
  
  • What occurs in this herniation?
  • What nerve can be compressed?
    
    • How does this manifest?
  • What artery can be compressed?
    
    • What part of the brain can have an ischemic injury because of this?
  • If this herniations progresses to compress the midbrain
    
    • What peduncle will compresses?
    • How does this manifest, and what is the name of this deformation?
    • What happens to consciousness?

Answer 11

Question 12

Hydrocephalus

• What is the definition of CSF?
• What are 2 things is hydrocephalus usually a consequence of?

Answer 12

Question 13

Hydrocephalus

• If the cranial sutures are fused, what can hydrocephalus cause besides increased ventricular expansion?
  
  • What will it not cause a change in?

Answer 13

Question 14

Trauma

• What is CTE?
  
  • What is characterized by?

Answer 14

Question 15

Herniation

• What is the definition of brain herniation?
  
  • What is this usually the result of?
• What divides the intra-cranial compartment?
• If a herniation leads to a compromised blood supply, what 3 main things can occur?

Answer 15

Question 16

Hydrocephalus

• What produces CSF?
• What 2 foramina does it flow through in order to get into the subarachnoid space?
  
  • Hint: What is A and what is B?
• What absorbs CSF?
• What regulates the CSF volume?

Answer 16

Question 17

Subdural Hematoma

• When do symptoms manifest after the injury?
• Where are they most common?
• Why do people get neurological symptoms?
  
  • What kind of symptoms do they have?

Answer 17

Question 18

Subdural Hematoma

• What is the structure that can tear from rapid movement, causing a subdural hematoma?
• Where does blood go?
• Why does blood appear to be between the dura and arachnoid, rather than between the twp laters of the dura?

Answer 18

Question 19

Herniation

• What are the 3 types of brain herniations?
  
  • Which is the most caudal and which is most rostral?

Answer 19

Question 20

Hydrocephalus

• Noncommunicating hydrocephalus
  
  • Do all the ventricles enlarge or just one?
  • What is the most common cause of this (2)? Hint: Say where in the brain…

Answer 20

Question 21

Herniation

• Transtentorial (uncinate) Herniation
  
  • What kind of hemorrhage is associated with this herniation?
    
    • `What is thought to be the reason this hemorrhage occurs?

Answer 21

Question 22

Trauma

• Old TBIs
  
  • What do they look like
  • What part of the gyri do they involve?
  • What can be seen inside the macrophages around them
  • What other cells are often around these lesions?

Answer 22

Question 23

Subdural Hematomas

• Why do older adults have a high rate of subdural hematomas?
• Why do infants have a high rate of subdural hematomas?

Answer 23

Question 24

Hydrocephalus

• If a brain disease causes loss of brain volume like neurodegeneration, what can occur?
  
  • Is the answer to the above question of really any clinical cognizance?

Answer 24

Question 25

Trauma

• When does morphological evidence of an injury usually occur?
  
  • Name 3 types of evidence of this?

Answer 25

Question 26

Herniation

• Subfalcine (cingulate) herniation
  
  • What happens to in this herniation?
  • Can it be unilateral or bilateral?
  • What artery can be compressed by this?

Answer 26