6

Question 1

Neuropathology:
– Closed-head injury:
* Secondary effects:

Answer 1

– cerebral oedema, subdural and epidural hematomas -> raised intracranial pressure
– but also hypoxia and infection, metabolic changes including hypothermia, electrolyte (calcium, chloride, magnesium) imbalance and respiratory difficulties

Question 2

Post-traumatic amnesia (PTA):

Answer 2

– Period of confusion when a person comes out of coma
– Reliable predictor of functional and cognitive recovery in children as well (Konigs, 2012, Briggs, 2015)
– Special version for children

Question 3

Recovery:
* After mild brain injury

Answer 3

– Initially,
* possibly altered consciousness,
* cognitive impairments (processing speed, attention, memory, executive function)
* Psychological status (irritability, mood disorders)
– More protracted recovery in children and adolescents
than in adults
– Usually followed by good recovery (not in about 20%)

Question 4

Recovery:
* Moderate or severe brain damage usually followed by three stages:

Answer 4

– Acute stage: Medical factors and survival come first
– Early rehabilitation: Identify the disorders and try to
maximise recovery
– Chronic stage: Acceptance of and adjustment to permanent disorders, reintegration. Support particularly important during developmental transitions

Question 5

Causes
* Reduced re-uptake of CSF because of

Answer 5

– Intraventricular haemorrhage (in babies with low birth
weight)
– Inflammation in which the archnoid granulations are affected
– Subarachnoid haemorrhage

Question 6

• Acquiredhydrocephalus
• Arisesduringorafterbirth
  – Usually of the communicative type – Causes

Answer 6

Intraventricular hemorrhage (IVH):

This is bleeding within the ventricles of the brain, commonly occurring in premature babies with low birth weight. It can cause damage to brain tissue and interfere with the flow of cerebrospinal fluid (CSF), potentially leading to hydrocephalus.
Inflammation affecting the arachnoid granulations:

Inflammation can damage the arachnoid granulations, which are responsible for absorbing CSF into the bloodstream. This disruption can affect CSF reabsorption, leading to CSF accumulation and possibly hydrocephalus.
Subarachnoid hemorrhage (SAH):

This occurs when there is bleeding in the subarachnoid space (between the brain and the membrane covering it). It often results from trauma or the rupture of blood vessels, and can lead to increased pressure on the brain, hydrocephalus, and other neurological complications.

Question 7

• Congenital hydrocephalus
  – Arises during the embryonic phase. – Mostly obstructive
  – Often associated with disorders of the embryo genesis such as

Answer 7

Spina bifida (open rug):

A birth defect where the spinal cord does not fully develop or close, leading to neurological defects and an increased risk of hydrocephalus. This is because abnormal spinal cord development can affect the brain’s CSF drainage, leading to fluid buildup.
Aqueduct stenosis:

The Aqueduct of Sylvius, a narrow channel that connects the third and fourth ventricles, becomes narrowed or blocked. This prevents normal CSF flow, causing fluid to accumulate in the brain, leading to obstructive hydrocephalus.
Dandy-Walker syndrome:

A developmental disorder where the midline of the cerebellum does not form properly, and the fourth ventricle becomes enlarged. This affects CSF circulation and absorption, often causing hydrocephalus