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Sem 4 - Nervous System > Head Injury > Flashcards

Head Injury Flashcards

1
Q

What are the types of head injury?

A

Primary vs secondary

Traumatic vs non-traumatic

Mild vs moderate vs severe

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2
Q

What is primary head injury?

A

Head injury occurring immediately after head trauma

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3
Q

What is secondary head injury?

A

Head injury occurring a while after the head trauma

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4
Q

What are the types of primary head injury?

A

Focal

Diffuse

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5
Q

What are the types of primary focal head injury?

A

Haematoma

Contusion

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6
Q

What are the types of a primary focal haematoma?

A

Extradural

Subdural

Intracerebral

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7
Q

What are the types of a primary focal contusion?

A

Coup contusion

Contre-coup contusion

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8
Q

What are the types of a primary diffuse head injury?

A

Concussion

Diffuse axonal injury

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9
Q

What are the types of traumatic head injury?

A

Open

Closed

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10
Q

What is an open traumatic head injury?

A

Something piercing the skull and dura, exposing the brain

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11
Q

What is a closed traumatic head injury?

A

The brain is not exposed

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12
Q

What are the causes of traumatic head injury?

A

Falls

Accidents

Abuse

Surgery

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13
Q

What are the types of non-traumatic head injury?

A

Infection

Stroke or TIA

Tumour

Metabolic disorder

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14
Q

What is a cerebral contusion?

A

Refers to head trauma causing brain to hit bony prominences in the skull or folds of dura

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15
Q

What does a contusion result in?

A

Micro-haemorrhages in the brain

Cerebral oedema, raised intracranial pressure, coma

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16
Q

What is a coup contusion?

A

Injury to brain at the site of impact

17
Q

What is a contre-coup contusion?

A

Injury to brain on opposite side of impact, due to brain being physically shaken in the skull

18
Q

What is a concussion?

A

Refers to head trauma causing stretching and injury of axons

19
Q

What does a concussion result in?

A

Impaired neurotransmission
Loss of ion regulation
Reduction in cerebral blood flow

-all lead to temporary brain dysfunction

20
Q

What is post-concussion syndrome?

A

Group of symptoms and signs due to the previous damage to the brain

21
Q

What are some signs and symptoms of post-concussion syndrome?

A

Headache

Sensitivity to light or noise

Dizziness

Sleep disturbance

Difficulty concentrating

Difficulty remembering new information

22
Q

What is diffuse axonal injury?

A

Shearing of interface between grey and white matter

23
Q

What types of head trauma cause diffuse axonal injury?

A

Acceleration, deceleration or rotational injuries to the head

24
Q

What is a complication of diffuse axonal injury?

A

Axonal death, cerebral oedema, raised intracranial pressure and then a coma

25
Q

What is a basilar skull fracture?

A

Bony fracture in the base of the skull

26
Q

What are the signs and symptoms of a basilar skull fracture?

A

Raccoon eyes

CSF otorrhea, meaning CSF leaks into middle ear

CSF rhinorrhea, CSF leaks from the nose

Battle sign

27
Q

How does CSF leak out through the nose?

A

CSF leaks from middle ear through Eustachian tube into nasopharynx

28
Q

Why does a basilar skull fracture give bruising?

A

Tears of dura and blood vessels

29
Q

Why does a basilar skull fracture give CSF leakage?

A

Tears in meninges

30
Q

How is a basilar skull fracture treated?

A

Elevation of depressed skull fractures

Control intracranial pressure

Persistent CSF leaks treated by surgery

Seek out and treat complications, likely to have other injuries due to amount of force required to break base of skull

31
Q

What are the features of a mild head injury in terms of

  • GCS score
  • duration of post traumatic amnesia
  • duration of loss of consciousness?
A

GCS score 13-15

Post-traumatic amnesia lasts less than 1 day

Loss of consciousness lasts less than half an hour

32
Q

What are the features of a moderate head injury in terms of

  • GCS score
  • duration of post-traumatic amnesia
  • duration of loss of consciousness
A

GCS score 9-12

Post-traumatic amnesia lasts less than a week

Loss of consciousness lasts less than 24 hours

33
Q

What are the features of a severe head injury in terms of

  • GCS score
  • duration of post-traumatic amnesia
  • duration of loss of consciousness
A

GCS score 3-8

Post-traumatic amnesia lasts more than a week

Loss of consciousness lasts more than 24 hours

34
Q

What are the criteria for an urgent head CT scan?

A

GCS score less than 13 whenever
GCS score less than 14, two hours after head injury

Depressed skull fracture 
Focal neurological deficit
Seizure when don’t usually have them
Two or more episodes of vomiting
Loss of consciousness and are above 65 or have coagulopathy or dangerous mechanism of injury, antegrade amnesia more than 30 minutes
35
Q

What is antegrade amnesia?

A

Loss of memory of what has just occurred

36
Q

Why is loss of consciousness and being above 65 an indication for urgent head CT scan?

A

Subdural haematoma more likely

Due to brain shrinking with age, increased tension on bridging veins, more likely to rupture

37
Q

Why is loss of consciousness and coagulopathy an indication for an urgent CT head scan?

A

Taking warfarin and heparin gives increased risk of bleeding

Sem 4 - Nervous System (25 decks)

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