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pathophysiology > brain trauma and injury - Sheet1 > Flashcards

brain trauma and injury - Sheet1 Flashcards

1
Q

What is a Traumatic Brain Injury (TBI)?

A

An alteration in brain function or evidence of brain pathology caused by an external force.

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2
Q

Which gender has the highest incidence of TBI?

A

Males.

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3
Q

What are common causes of TBI in children and older adults?

A

Falls.

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4
Q

What are the two classifications of primary TBI injury?

A

Focal (affects one area of the brain) and diffuse (affects more than one area, such as with diffuse axonal injury (DAI)).

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5
Q

What is a secondary injury in TBI?

A

An indirect consequence of the primary injury, involving cellular and molecular brain events and systemic responses.

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6
Q

What is the mechanism of closed (blunt) trauma?

A

Caused by accelerating, decelerating, shearing, crushing, and/or compressing forces.

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7
Q

What are manifestations of blunt trauma?

A

Pain, mental status changes (lethargy, confusion), focal neurological changes, ecchymosis, and bleeding.

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8
Q

How is blunt trauma diagnosed?

A

History and physical exam, labs (BMP, CBC, Coags), and head CT.

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9
Q

What is penetrating (open) trauma?

A

An impalement of the head by a foreign object that breaks the dura and exposes cranial contents to the environment.

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10
Q

What are common complications of penetrating trauma?

A

Meningitis, hemorrhagic injury, and skull fracture.

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11
Q

What is the mechanism behind epidural hematoma?

A

Arterial or venous bleeding occurs when an artery or vein is ripped away from the skull, leading to a rapid increase in ICP.

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12
Q

What are the manifestations of epidural hematoma?

A

Severe headache, nausea/vomiting, drowsiness, confusion, seizures, hemiparesis, rapid mental status change, or a lucid period followed by unconsciousness.

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13
Q

What is the most common cause of epidural hematoma?

A

Motor vehicle accidents (MVAs).

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14
Q

What is a subdural hematoma?

A

A brain bleed in the subdural space, typically from venous bleeding.

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15
Q

How are subdural hematomas classified?

A

Acute (within hours), subacute (48 hours - 2 weeks), or chronic (weeks to months).

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16
Q

What are common manifestations of acute subdural hematomas?

A

Headache, drowsiness, restlessness, agitation, slowed cognition, and confusion.

17
Q

What are common manifestations of chronic subdural hematomas?

A

Chronic headaches and tenderness at the site of injury.

18
Q

What is an intracerebral hematoma?

A

A hematoma that acts as an expanding mass, increasing ICP and compressing brain tissues, leading to edema and ischemia.

19
Q

Who is at high risk for intracerebral hematomas?

A

People on anticoagulant medications.

20
Q

When do intracerebral hematomas typically appear?

A

3-10 days after injury.

21
Q

What are the manifestations of intracerebral hematomas?

A

Decreasing level of consciousness (LOC), confusion, headache, and neurological deterioration.

22
Q

What is diffuse axonal injury (DAI)?

A

Injury to axons caused by shearing or stretching of nerve fibers, affecting widespread areas of the brain.

23
Q

What are the mechanisms of DAI?

A

Rotational and twisting movements, as well as acceleration-deceleration forces.

24
Q

What does the severity of DAI depend on?

A

The amount of shearing force applied to the brain.

25
Q

What is a mild concussion?

A

A mild traumatic brain injury with temporary axonal disturbances causing attention and memory deficits, but no loss of consciousness. May cause headache.

26
Q

What is a moderate concussion?

A

Loss of consciousness for more than 30 minutes, with posttraumatic amnesia lasting 24 hours or more. May involve basal skull fracture and brain function changes.

27
Q

What are some long-term deficits associated with moderate concussions?

A

Permanent deficits in attention, working memory, data processing, vision, language, and mood.

28
Q

What is a severe concussion?

A

A GCS score of less than 8, brainstem signs, intracranial contusions, hematomas, or lacerations with loss of consciousness lasting more than 24 hours.

29
Q

What are complications of a severe concussion?

A

Increased ICP (often 4-6 days after injury), pulmonary complications, sensorimotor and cognitive deficits, permanent neurological/cognitive deficits.

30
Q

What is a coup injury?

A

Injury occurring at the site of impact, often due to the head whipping backward.

31
Q

What is a contrecoup injury?

A

Injury occurring when the brain rebounds and hits the opposite side of the skull, usually from the head whipping forward.

32
Q

What are contusions, and how do they occur?

A

Blood leaks from an injured blood vessel as a result of the force of impact.

33
Q

What are the common manifestations of a brain contusion?

A

Loss of consciousness, usually lasting less than 5 minutes.

pathophysiology (56 decks)

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