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Neurology Clinical > Forensic Pathology of Head injuries > Flashcards

Forensic Pathology of Head injuries Flashcards

1
Q

What is a traumatic head injury assed by

A

GCS ( ocular , motor, verbal )

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2
Q

List 4 types of head injury

A

1- Blunt
2- Missile
3- Acc/Dec forces
4- Penetrating

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3
Q

What is the primary damage ( immediate ) that could occur from a traumatic head injury

A 
1- scalp laceration 
2- skull fracture 
3- cerebral contusions 
4- cerebelar lacerations 
5- intracranial haemorrhage 
6- diffuse axonal injury
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4
Q

What is the secondary ( delayed ) damage that could occur from a traumatic head injury

A

1- Ischaemia
2- hypoxia
3- cerebelar swelling
4- infection

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5
Q

What type of diffuse distribution could occur from a head injury

A

1- Diffuse axonal injury
2- diffuse vascular injury
3- hypoxic ischaemic damage
4- diffuse brain swelling

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6
Q

What are contusions

A

Bruises

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7
Q

What are abrasions

A

scratches / grazes

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8
Q

What are lacerations

A

cuts / tears

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9
Q

What are the possible types of skull fractures

A 
1- linear 
2- Depressed 
3- Contra-coup 
4- Hinge 
5- Ring 
6- Diastatic 
7- Pond ( ripple / spider web )
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10
Q

Where is a extradural haemorrhage

A

Between the dura and the skull

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11
Q

What causes a extradural haemorrhage

A

Torn vessels in the meninges in association with the skull.

Common : a fracture to the squamous temporal bone causing damage to middle meningeal artery

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12
Q

Death from to extradural haemorrhage is normally due to

A

Cerebral compression and herniation

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13
Q

What is a lucid interval in extradural haemorrhage

A

Time between injury and death where there is an slow accumulation of blood. person will be conscious

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14
Q

What usually causes a subdural haemorrhage

A

tearing of bridging veins that empty into the superior sagittal sinus

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15
Q

Where is a subdural haemorrhage

A

between inner surface of dura and arachnoid layer

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16
Q

Which group of people are at a high risk of subdural haemorrhage

A

Elderly and alcoholics

17
Q

Which haemorrhage can occur after a relatively minor head injury

A

Subdural haemorrhage

18
Q

What is the normal presentation of a subdural haemorrhage within 48hrs

A

Headache and maybe confusion

19
Q

What are the common areas of cerebral contusions

A

1- Frontal poles
2- Orbital surface of frontal poles
3- Temporal poles
4- Cortex adjacent to Sylvia tissue

20
Q

What is Coup injury vs contrecoup injury

A

Coup: injury at the point of contact
Countercoup: injury to surface opposite to the point of contact

21
Q

When does a countercoup injury occur and what does it indicate

A

Occurs : after sudden deceleration

Indicated movement of head at injury

22
Q

What is a cerebral contusion

A

superficial bruise of the brain

23
Q

What are the possible bleeding sources of a traumatic subarachnoid

A

1- severe contusions / lacerations
2- skill fracture tearing vessels at brain base
3- rupture of vertebral arteries dissection
4- blood form intraventricular haemorrhage

24
Q

Due to blockage of CSF subarachnoid haemorrhage may cause ..

A

Hydrocephalus

25
Q

What is diffuse axonal injury

A

Widespread traumatic axonal image

26
Q

What is the clinical presentation of diffuse axonal injury

A

1- unconscious from moment of impact
2- no lucid interval
3- remains unconscious in a vegetative state or severely disabled

27
Q

What is the histological presentation of diffuse axonal injury

A

1- wide spread axonal swelling

28
Q

Clinical features of raised ICP

A 
1- Headache 
2- Vomiting 
3- Confusion 
4- Focal neurological signs : paralysis , hemianopia , dysphasia 
5- depressed conscious level 
6- seizure 
7- papilloedema
29
Q

What are the effects of raised ICP

A

1- Flattening of gyros pattern
2- compression of ventricle on same side as lesion
3- lateral shift of midline structures is lesion unilateral
4- internal herniation

30
Q

What is uncle herniation

A

When raised ICP causes portions of the brain to move form one intracranial compartment to another

31
Q

What is a duet haemorrhage

A

small linear areas of bleeding in the midbrain and upper pons of the brainstem. caused by traumatic downward displacement of brainstem

Neurology Clinical (14 decks)

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