Head Trauma

Question 1

Blood clot between Inner Table of the skull and Dura Mater; “lens” shape on CT/MRI; caused by tearing of middle meningeal artery; grows quickly with potential for herniation and mass effect

Answer 1

Epidural Hematoma

Question 2

Blood clot between the Dura and Arachnoid Mater; MORE COMMON; due to tearing of bridging veins; crescent shape on CT/MRI; can cause herniation and mass effect

Answer 2

Subdural Hematoma

Question 3

Bleed underneath the Arachnoid mater; almost ALWAYS caused by head trauma

Answer 3

Subarachnoid Hemorrhage

Question 4

Hemorrhage resulting from the surface of the brain making contact with the bony protuberances of the base of the skull; lacerations of pia mater is possible

Answer 4

contusion (cortical hemorrhage)

Question 5

What portions of the brain are most prone to Contusions

Answer 5

Frontal pole
Temporal pole
inferior frontal gyri
sylvian fissures

Question 6

Coup vs. Contrecoup

Answer 6

Coup- the bruising is directly under the surface injury

Contrecoup- the bruising is on the opposite side of the surface injury

Question 7

Injury when the brain rapidly shifts inside the skull; MOST common cause of coma and severe disability after traumatic brain injury

Answer 7

Diffuse Axonal Injury

Question 8

Triad of acute encephalopathy, subdural hematoma and retinal hemorrhages; brain swelling causes inc. ICP, decreased perfusion, ischemic injury and death

Answer 8

Abusive Head Trauma (“Shaken Baby Syndrome”)

Question 9

What clinical features/signs indicate a basilar skull fracture?

Answer 9

Periorbital bruising, Battle’s sign, and otorrhea/rhinorrhea