Chapter 56. Trauma of the Nervous System, Chapter 56A. Basic Neuroscience of Neurotrauma

Question 1

Question 56A-1: 
Serial scans on a patient with severe head injury show increasing ventricular size and cortical atrophy. Which is the interpretation of these findings? 
A.  Obstructive hydrocephalus 
B.  Communicating hydrocephalus 
C.  Progressive cerebral atrophy 
D. None of these

Answer 1

Answer 56A-1: C.
Progressive tis.sue loss can develop following
severe head Injury. Development of increased
ventricular size could suggest hydrocephalus
but is less likely than progressive tissue loss.’
(p1118)

Question 2

Question 56A-2:
Which of the following correctly summarizes the adverse effects of repetitive head injury?
A. Repeated head injury increases the risk of degenerative dementia later in life
B. Repeated head injury has a greater effect on brain function than single injuries
C. Hypoxia or hypotension following a head injury can serve as a second injury
D. All ofthese are true

Answer 2

Answer 56A-2: D.
Repeated head injury has a greater deleterious
effect than single injuries. This makes
clinicians cauliuus about returning athletes to
sport when there is a significant risk of head
injury. After trauma, there may be hypoxia or
hypotension which can further exacerbate the
condition, serving as a second injury. (p1119)

Question 3

Question 56A-3: 
Shearing injuries are most common in which portion of the brain? 
A.  Fronta-polar cortex 
B.  Anterior temporal cortex 
C.  Deep white matter 
D.  Brainstem

Answer 3

Answer 56A-3: C.
Axonal shearing is most conunon in the
cerebral white matter, especially during
acceleration-deceleration injuries. There is
shearing of the axons along with damage to
the vessels. (P1119-1120)

Question 4

Question 56A-4: 
Patients with head injury who sustain subsequent hypoxia have a poorer prognosis. 
Which are potential causes? 
1.  Increased cerebral edema 
2.  Second-injury effect 
3.  Cerebral hemorrhage 
4.  Hypothermia 
Select: A = 1.2.3. B = 1.3. C = 2. 4. D = 4 only. E = All

Answer 4

Answer 56A-4: A.
Hyperthennia is more common than
hypothermia in patients with head injwy. This
can be in pan due to increased core
temperature in patients with fever, however, in
some patients, intracranial temperature may be
even higher than core temperature. Therefore,
hyperthennia serves essentially as a second
injury. (P1121)