Brain Trauma

Question 1

In imaging studies, what are the traverse images called

Answer 1

axials

Question 2

In imaging, on which sequence does CSF show up as bright white

Answer 2

T2

Question 3

why are x-rays rarely used in head trauma

Answer 3

no soft tissue info
require multiple planes (multiple images from different sides)
not really useful

Question 4

why are CTs helpful in head trauma?

Answer 4

fast
detailed info about bones and blood and foreign bodies
contain images in all planes

Question 5

downsides of CTs

Answer 5

tons of radiation
some info but not great for soft tissue
don’t use on preggos or peds

Question 6

why do we like MRIs?

Answer 6

detailed soft tissue images (like brain and spinal cord!)

no radiation

Question 7

downside of MRIs?

Answer 7

Slooooowwwww
expensive
can’t use with some implant devices or foreign bodies (especially in the eye)

Question 8

what constitutes a traumatic brain injury?

Answer 8

very broad
any blow or bump that disrupts brain function
can be mild to severe

Question 9

what is the most common cause of TBI deaths

Answer 9

falls associated with old age

Question 10

more common causes of TBI deaths in younger people?

Answer 10

self harm, MVAs, and assaults

Question 11

what is mild TBI

Answer 11

loss of consciousness- less than 30 min
Glascow Coma Scale 13-15
posttraumatic amnesia less than 24 hours

Question 12

what is the definition of a concussion

Answer 12

no standard definition

mild TBI, variable symptoms

Question 13

what labs do you order in concussion management

Answer 13

CBC
BMP
Coags
UA
U tox

Question 14

how do you measure consciousness of a patient

Answer 14

glascow coma scale

Question 15

what GCS score is associated with an 80% mortality/vegetative state?

Answer 15

less than 5

Question 16

what GSC score is associated with greater than 90% recovery

Answer 16

greater than 11

Question 17

how long does it take for most symptoms of concussion to resolve?

Answer 17

7-14 days

Question 18

why don’t atheletes returned to play immediately?

Answer 18

great risk with repetitive concussions

Question 19

how long do symptoms last to be considered post concussive syndrome

Answer 19

3 months or longer

Question 20

differential for post concussive syndrome

Answer 20

delayed hydrocephalus

post traumatic seizures

Question 21

what red flags would make you order a CT for a concussion? (8 things)

Answer 21

severe headache
vomiting
age >60
intoxication
amnesia
post traumatic seizure
blood thinner use
trauma above clavicle

Question 22

when you order a head CT for concussion- what are you looking for?

Answer 22

bleeds!
hydrocephalus
cerebral swelling
skull fracture
midline shift

Question 23

what kind of bleed is crescent shaped?

Answer 23

subdural hematoma- follows bone

Question 24

what kind of bleed is balloon shaped?

Answer 24

epidural hematoma- pushes into the brain

Question 25

are subdural hematomas or epidural hematomas more likely to require surgery?

Answer 25

epidural hematoma- emergent surgery to prevent herniation

Question 26

are subdural hematomas or epidural hematomas more likely to be chronic

Answer 26

subdaural hematoma- can also be acute or subacute

Question 27

what is the condition in which the brain moves into a different condition than it should be in

Answer 27

herniation

Question 28

what are the common causes of herniation?

Answer 28

swelling, hematoma, tumor

Question 29

where are the two most common locations of herniation?

Answer 29

central

uncal