brain trauma Flashcards
The brainstem & cerebellum sit in which cranial fossa?
posterior cranial fossa
Which is more concerning–the external or internal head injuries?
internal head injuries!
Where is the grey matter in the brain?
on the outsidethe white matter is on the insideneuronal connections b/w the 2
What is a concussion?
Transient alteration in mental function due to angular rotation of brain structuresNo gross or microscopic changesLoss of consciousness is typicalCT and MRI is normal
T/F you need to have LOC to have a concussion.
False. May never lose consciousness & have a concussion.
What are some symptoms of a concussion?
HeadacheNausea and or vomitingRinging in the earsDizzinessVacant StareFeeling slowed down“Seeing stars”Sensitivity to lightSleep problemsFeeling confusedPoor balance or coordinationSlow or slurred speechPoor concentrationDelayed responses to answering questionsDecreased ability to playEmotional or personality changesInappropriate behaviourExcessive crabbiness
T/F Linear fractures leave the brain exposed to the air & environment.
False. Compound fractures
Anyone in the emergency room with black eyes w/o trauma to the eyes-you should think about what?
blood comes from base of skull fracture**can also see blood accumulation behind the ear
Why is it super important to pick up base of skull fractures?
b/c CSF may be leaking out & put patient at risk for meningitis
Where are extra-axial intracranial hematomas located?
outside the brainintra-axial is inside the brain
What is an epidural hematoma?
blood accumulates outside of the dura & puts pressure on the brain & brainstem. Injure brainstem & lose consciousness.**may begin from a skull fracture hurting the middle meningeal artery
What is a good way to tell about brainstem compression?
pupil dilation & 3rd cranial nerve palsy (ipsilateral)
T/F Epidural hematoma has a normal brain.
True.
Who usu gets an epidural hematoma?
younger age group, more often menoften have lucid intervals
T/F Epidural hematomas are more lethal than acute subdural hematomas.
False. Subdural worse–actual brain damage
What is an acute subdural hematoma?
more lethal than EDHno “lucid interval”includes: tearing of bridging veinsparenchymal damageNeeds craniotomyMortality 50-90%
What is a cerebral contusion?
Bruising of the brainCauses swellingMay cause local dysfunction or pressure problemsTypically frontal/temporal/ occipital
What is diffuse axonal injury?
Shear injury at grey/white interface related to rapid acc/decelerationSevere dysfunction; comaCT relatively normalLittle swellingCan cause classical corpus callosum and rostral brainstem injuries
Which things are involved in secondary injury following TBI?
cerebral edema & increased intracranial pressurehypotension & hypoxemia cerebral hypoperfusionResults: Neuronal deathUltimately caused by cerebral ischemiaIncreases morbidity
What is the Monroe-Kelly Doctrine?
we have a finite amount of room in the head…don’t want to increase the volume of something else while treating.
Why do you get a CT before you do a spinal tap?
b/c they could have a tonsillar herniation syndrome
What are other examples of herniation syndromes?
uncal
subfalcine
central
What are the components of the Glasgow Coma Scale?
Motor (1-6)Verbal (1-5)Eye-Opening (1-4)3-15 is the range.
Explain what 1-6 is for motor response.
1-no movement2-abnormal extension3-abnormal flexion4-withdraws to pain5-localizes to pain6-obeys commands