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MJ- F2 E4- Neuro > Concussion- SG > Flashcards

Concussion- SG Flashcards

1
Q
  • A complex pathophysiological process affecting the brain induced by traumatic biochemical forces
  • Mild traumatic brain injury (mTBI)
  • May not actually involve head trauma
A

Concussion

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2
Q

Concussion

  • ___ onset of neurologic dysfunction that resolves spontaneously
  • Can result in pathological changes producing ___ rather than ____ injury
  • Result is a graded set of sxs that may or may not include ___ and does NOT involve ___ abnormalities on neuroimaging.
A
  • Rapid
  • Functional, rather than structural injury
  • LOC / structural
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3
Q
  • Annual incidence of ___ exceeds other neuro dx (parkinson, stroke, MS, alzheimer dz)
  • Do most TBIs result in concussions or not?
A
  • TBI
  • 75% of TBIs each year are concussions
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4
Q

3 age groups most likely to sustain TBI

A
  • Children 0-4 yrs
  • Adolescents 15-19 yrs (accidents / sports)
  • Adults 65+ yrs (falls)
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5
Q

Which age group have the HIGHEST rates of TBI-related hospitalizations/death?

A

Adults > 75 yrs

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6
Q

Which gender is at highest risk of TBI/Concussion in all age groups?

A

Males

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7
Q

TBI/Concussions are major source of disability for which group of people?

A

Soldiers returning from Irag/Afghanistan

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8
Q

Why is it difficult to obtain estimates of yearly TBIs from sports injuries?

A

The injured not seeking care

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9
Q
  • 4 sports associated w/ Concussions
  • Which one has internationally the highest rate?
A
  • Football
  • Ice Hockey
  • Soccer
  • Rugby (highest rates)
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10
Q

What is the word for the movement of brain on:

  • Initial impact?
  • Secondary impact?
A
  • Coup
  • Contre-coup
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11
Q

3 states of confusion associated w/ Concussion

A
  • Dazed
  • Stunned
  • Answers slowly
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12
Q

Types of memory loss from Concussions

A
  • Retrograde amnesia
  • Anterograde amnesia
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13
Q

2 visual disturbances associated w/ Concussions

A
  • Double vision
  • Light sensitivity
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14
Q

Post-Concussive Sxs last how long?

  • What are they? (6)
A

Days - Months

  • Chronic HA
  • Short term memory difficulties
  • Fatigue
  • Difficulty sleeping
  • Personality changes (irritable/mood swings)
  • Sensitivity to light / noise
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15
Q

Post-Concussive Syndrome persists for more than ___.

A

1 week

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16
Q

Post-Concussive Syndrome is “clustering” of what 3 difficulties?

A
  • Physical
  • Somatic
  • Sleep-related

Difficulties

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17
Q

3 cognitive difficulties of Post-Concussive Syndrome

A
  • Memory
  • Problem solving
  • Decreased concentration
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18
Q

When should a patient w/ Concussion be evaluated clinically?

A
  • At time of incident
  • After incident (FU)
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19
Q

What tool is used for assessing concussions in athletes?

A

Sports Concussion Assessment Tool (SCAT5)

20
Q

What imaging if any is recommended for concussions?

A

CT

21
Q

Indications for CT after Concussion

  • GCS < ___ how many hours after injury?
  • Suspected ________
  • Sign of ___ skull fx
  • ___+ episodes of vomiting
  • ___ y/o or older
  • Amnesia for events occuring >__ mins prior to impact
  • Dangerous mechanism
  • Neuro deficit
  • Seizures
  • Bleeding diathesis or anticoagulant use
  • *****Or if return visit for reassessmen of head injury*****
A
  • 15
  • open/depressed skull fx
  • Basilar
  • 2+
  • 65
  • 30
22
Q

4 signs of Basilar Skull Fx

A
  • Racoon eyes
  • Battle sign
  • Hemotympanum
  • CSF rhinorrhea
23
Q

Tx of Concussion

  • First thing is: ______
  • Rest and ___ for HA
  • Gradual increase to _____
  • Can pt return to play that day?
  • Return to play: not until ____
A
  • # 1: removal from event / activity
  • acetaminophen
  • full athletic activity
  • AZ law: must be evaluated before returning to sport
  • all sxs are gone and no meds required
24
Q

DO NOT give which 2 medications for concussions?

A
  • NSAIDS: increase risk of bleed
  • Morphine: sedates/decreases level of consciousness
25
Q

3 Intracranial (CNS) Tumors

A
  • Astrocytoma (benign usually)
  • Glioblastoma
  • Meningioma
26
Q

CNS tumors arise from cells within CNS or from ____ cancers that have _____.

A

systemic / metastasized to CNS

27
Q

CNS Tumors

  • ___ and ____ account for 2/3 of primary adult brain tumors
  • ____ is most common in children
  • ____ is most common in adults w/ median age of ___ y/o
A
  • Meningiomas & Glial Tumors
  • Low-grade astrocytoma
  • Glioblastoma / 64 yrs
28
Q

CNS Tumors

  • Slight ___ predominance in malignant tumors
  • Slight ___ predominance in meningiomas
A
  • Male
  • Female
29
Q

3 CNS tumors of higher prevalence in black population

A
  • Meningioma
  • Pituitary tumors
  • Craniopharyngioma
30
Q

What classification is used for CNS tumors?

A

WHO

31
Q

5 most common metastatic tumors –> CNS

A
  • lung
  • breast
  • renal
  • melanoma
  • colorectal
32
Q

A mass of well differentiated, non-invading, non-metastasizing cells

A

benign tumor

33
Q
  • Capable to grow, invade, and spread
  • Anaplasia: cells w/ poor differentiation, losing morphological characteristics of mature normal cells
A

Malignant

34
Q
  • Develops from epithelial cell
  • Tissues that line surfaces
  • Endodermal, mesodermal, & ectodermal layers
A

Carcinoma

35
Q
  • From mesenchymal origin
  • Cancerous bone, cartilage, fat, muscle, vascular, hematopoietic cells
  • (connective tissues)
A

Sarcoma

36
Q
  • Benign tumor of epithelial tissue w/ glandular origin
A

Adenoma

37
Q
  • _____ can be useful to decrease edema, thus decreasing symptomatic effects of tumors
A

Steroids:

Dexamethasone

38
Q

2 main clinical manifestations of CNS tumors

A

1: Focal seizures (50-80%)

39
Q

4 Focal Signs/Sxs of CNS tumors

A
  • Weakness
  • Sensory loss
  • Aphasia
  • Visual spatial dysfunction
40
Q

****3 signs of Increased Intracranial Pressure (ICP) from CNS tumors***

A
  • Headache
  • Nausea/Vomiting
  • Papilledema
41
Q

What imaging would you order for CNS tumor?

A

Brain MRI with contrast

42
Q

Imaging for screening for systemic malignancy

A

CT

  • chest
  • abdomen
  • pelvis
43
Q

CNS tumor eval

  • Get an LP if ____ is suspected
A

leptomeningeal seeding

44
Q

What imaging for “some lesions”

(imaging is equivocal and non-neoplastic etiologies are being considered)

A

MR spectroscopy (type of MRI)

45
Q

CNS Tumor Diagnosis

  • Requires ____
  • Type of procedure depends on what 4 things?
  • ____ is used as adjunct for tumors in delicate areas (pt is awake)
  • ____ performed in OR to determine preliminary biopsy results and help surgeon decide whether or not to proceed w/ extensive resection
A
  • tissue sample for histopathologic / molecular study
  • Tumor: Type, Grade, Location, Operability
  • Functional MRI
  • Frozen Section
46
Q
A

MJ- F2 E4- Neuro (19 decks)

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