Block 1 CNS Trauma II

Question 0

What is a diastatic fracture?

Answer 0

A fracture across a suture
Suture widens
Children usually

Question 1

What is a basal skull fracture?

Answer 1

More force

Generally hematoma behind ear

Question 2

What are three parenchymal injuries?

Answer 2

Concussion
Direct parenchymal injury
Diffuse axonal injury

Question 3

What are characteristics of a concussion?

Answer 3

Altered consciousness
Change in momentum of the head
Amnesia, vomiting, dizziness
The brain bounces and stretches
No specific lesion

Question 4

What is second impact syndrome?

Answer 4

Second concussion before the first one heals
Can be fatal
Brain swells like crazy and rapidly
Due to arterioles inability to regulate diameter
Young athletes

Question 5

What is chronic traumatic encephalopathy?

Answer 5

Caused by repetitive brain injury
Behavioral/personality symptoms: aggressive, depressed, confusion, memory loss, apathy
Progressive dementia
Histologically looks like Alzheimer’s disease
Have higher concentrations of tau protein

Question 6

Four types of skull fractures?

Answer 6

Linear, depression, diastatic, basal

Question 7

What are direct parenchymal injures?

Answer 7

Injures right to the brain matter
Laceration
Contusion (bruising)

Question 8

What are two injuries of the direct parenchymal injuries?

Answer 8

Coup injury, injury upon direct impact

Countercoup injury, injury upon bounce back after the coup injury. Tends to be worse out of the two.

Question 9

What is a Diffuse Axonal injury?

Answer 9

Due to movement of the head in a rotational matter
Happens in “shaken baby syndrome”
Twisting shears axons or twists them
Common cause of persistent deficits of coma after trauma.
Damage can be permanent

Question 10

Diffuse axonal injury character?

Answer 10

Can be accompanied by mini hemorrhages

Accompanied by axonal spheroids

Question 11

What are the three types of traumatic vascular injury?

Answer 11

Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage

Question 12

What is the difference between hematoma and hemorrhage?

Answer 12

Hematoma is more contained

Hemorrhage is just blood everywhere around

Question 13

What are typical findings for an epidural hematoma?

Answer 13

Rupture the middle meningeal artery
Typically hit in the temple with a baseball
May have lucid period (feel ok for 5min) SIGN!
Neurological emergency
Conture is smooth

Question 14

What are characteristics of a subdural hematoma?

Answer 14

Cerebral vein shear
Between dura and subarachnoid
Typically in elderly patients, falls, seems ok.
May have acute or chronic symptoms long times after the injury
Not necessarily surgical emergency

Question 15

What are characteristics of a subarachnoid hemorrhage?

Answer 15

Blood in subarachnoid space
Often times not trauma but from ruptured berry aneurysms.
Typical setting is the worst headache I’ve ever had
Neurosurgical emergency
Spreads everywhere
Aneurysms often occur at break points