CNS Injury

Question 1

peak age groups in which head injuries occur

Answer 1

Males 2:1
24-35- MVC, falls, assaults, homicide, suicide, falls
0-4- child abuse
65+- falls at home

Question 2

Contact Injury

Answer 2

Skull fx
-linear, depressed, basral, diastaic, growing
Epidural Hematoma (w/ fx)
Contusion (brain bruise)

Question 3

Accl/Decell Injury

Answer 3

Subdural hematoma

Question 4

rotational injury

Answer 4

DAI- tangles but not plaques

Question 5

goal of treatment in head injuries

Answer 5

Prevent secondary injury

ICP Injury: elevated ICP decreased CBF further elevated ICP
Rx: minimizing ICP, maximize O2 delivery
Mannitol can reduce brain edema, catheters can help drain CSF

Question 6

intracranial pressure in head injury

Answer 6

A build of pressure will ultimately lead to a decrease/cessation in cerebral blood flow or brain herniation

Question 7

signs and symptoms of increased intracranial pressure

Answer 7

lethargy, poor responsiveness

Question 8

Subfalcine Herniation

Answer 8

cingulate dives beneath the falx, ACA is kinked–> ACA Stroke

Question 9

Central Herniation

Answer 9

herniation of the uncus downward bilaterally

Question 10

Uncal Herniation

Answer 10

uncal/ medial temporal lobe moves into the posterior fossa compressing the midbrain & ipsilateral (and rarely contralateral) cerebral peduncle hemiparesis & hemiplegia (CN III palsy) Kernohans notch. May hemmorgae in the brainstem. Duret hemorrhage.

Question 11

Tonsillar Herniation

Answer 11

cerebellar tonsils herniate into Forman magnum “coning” medulla is compressed leading to Cushing reflex: Bradycardia, hypertension. Abnormal cardiac/ respiratory. Usually from mass lesion in posterior fossa

Question 12

most common symptoms of concussion

Answer 12

Confusion, amnesia*

HA, dizziness, ↓ attention, memory problems, fatigue, irritability, depressed mood, intolerance to light and sound, sleep disturbances