DSA 23 Head and Spine Trauma Flashcards
dazed, confused, saw stars
concussion
is there amnesia in someone with a concussion?
yes
What is the physical examination features of someone who has a concussion?
NORMAL neurological exam
What is the mechanism of a concussion?
biochemical and ultrastructual abnormalities such as mitochondrial ATP depletion, and local disruption of blood bbrain barrier; RAS suffers the brunt of the trauma
What are the labs like in someone with a concussion?
normal
history of anticoagulant or antiplatelet use in someone who is elderly is at risk for??
subdural hematoma
What would you see on a brain CT for someone who has a subdural hematoma?
acute; blood in the subdural space
chronic; there may be water density fluid in the subdural space
you see a crescent_shaped hemorrhage that crosses the suture lines with a midline shift
What is the prognosis of a acute subdural hematoma?
lethal; if it was chronic it would be a gradual progressive condition that has a better prognosis
What is the treatment for a chronic subdural hematoma?
surgical evacuation if large and symptomatic but it may resolve on its own if small and clinically minimal
What is the treatment for a acute subdural hematoma?
surgical evacuation unless so small that the clinical implications are trivial
rupture of middle meningeal artery?
epidural hematoma
biconvex (lentiform) hyperdense blood collection on MRI
Epidural hematoma
lucid interval
epidural hematoma
Risk of transtentorial herniation?
epidural hematoma
risk of CNIII palsy?
epidural hematoma
Temporal bone fracture
epidural hematoma
treatment for epidural hematoma?
surgical evacuation
Etiology of intracerebral hemorrhage?
usually due to hypertension
What is the onset of a intracerebral hemorrhage?
acute
physical findings of someone with intracerebral hemorrhage?
FOCAL neurological deficits depending on where it is affected
treatment of intracerebral hemorrhage?
supportive; monitoring, head elevation, and bed rest
physical findings of a spinal cord injury
UMN, sensory deficits, and sphincter and autonomic changes below the level of the injury
temporary loss or depression of spinal reflex activity that occurs below a complete or incomplete spinal cord injury
spinal shock
can mimic a complete CORD lesion
spinal shock
What is the difference between an acute spinal shock injury and GBS?
GBS starts with tingling and loss of sensation in the extremities while spinal shock mimics a complete spinal cord lesion that causes paralysis
What is the best imaging for spinal cord injury?
MRI
risk associated with lumbar puncture?
epidural hematoma of the spinal cord
What causes epidural hematoma of the spinal cord?
fall or direct trauma
treatment of epidural hematoma?
surgical
sensory disturbance of the perineum
cauda equina syndrome
What has sphincter dysfunction
cauda equina syndrome, and myelopathy
best diagnostic feature for cauda equina syndrome?
MRI
Trauma to the lumbosacral spine below the level of L2
cauda equina syndrome
