Head trauma and spinal injury Flashcards
Where does traumatic axonal injury most commonly appear?
The corpus callosum
Is grey or white matter predominantly affected in vasogenic cerebral oedema?
White matter
Which type of cerebral oedema is responsive to steroid treatment?
Vasogenic
What is the volume of CSF?
150mL
What is a cause of chronic traumatic encephalopathy?
Repeated traumatic injury to the brain eg in boxers
What occurs if rising ICP can’t be compensated for?
There is herniation of brain hemisphere through dural openings
Brain perfusion can cease if ICP overtakes cerebral perfusion pressure (CPP)
What is vasogenic cerebral oedema caused by?
Blood-brain barrier disruption due to increased vascular permeability
What is a concussion characterised by?
Temporary lose of consciousness, respiratory arrest and reflexes
What are contusions?
Haemorrhagic necrosis in the brain
Can subdural bleeds cause raised ICP?
Yes
What are the longterm effects of diffuse axonal injury?
Brain atropy
What are some non-acute effects of traumatic injury?
Infection
Epilepsy
What are some acute secondary effects of traumatic injury?
Hypoxia
Ischaemia
Raised ICP
How much does the scalp bleed?
A lot
What is a common cause of concussion?
Rapid change of momentum of the brain
What is it called when skull fractures have splintering of bone?
Comminuted
What symptom is characteristic of subarachnoid bleeds?
A thunderclap headache
What is chronic traumatic encephalopathy characteristed by?
Brain atropy due to neuronal lose
Abnormal deposition of Tau protein
Often deposition of A-beta plaques in the cortex
When do subarachnoid haemorrhages generally occur?
Aneurysms following trauma
How do old cerebral contusions appear?
Drooping of brain tissue along gyri and deposition of orange tissue - indicative of healing by macrophages and scarring
What is hydrocephalus?
Dilation of the ventricles due to interruption of CSF flow - brain is damaged as a result
Diffuse vascular injury affects which vessels?
V. small vessels
Is grey or white matter affect in cytotoxic cerebral oedema?
Both
Subdural haemorrhages are more common in which age group? Why?
The elderly because atropy of the brain tends to greater tension on the subdural veins making them more likely to tear
Why are contusions on the base of the brain common?
Protuding, boney structures can be rubbed against
In which age group are epidural bleeds less likely? Why?
The elderly because their dura adheres more strongly to the skull
How does an atropied brain appear?
Enlarged ventricles
Thin corpus callosum
White matter is generally thinner
What is a contrecoup?
When the brain bounces against the back wall of the skull resulting in injury to both sides of the brain
What are the compensations for rising ICP?
Ventricles shrink
Gyri flatten out
Blood is forced out
What is cytotoxic cerebral oedema caused by?
Increased intracellular fluid secondary to neuronal, glial, or endothelial cell injury
What are common site for contusions on the base of the brain?
Inferior frontal lobe (eg olfactory bulbs)
Inferiorlateral temporal lobe
Subdural haemorrhage are due to damage to which vessels?
Subdural veins eg the superior cerebral veins
What determines the damage done by a bullet?
The velocity of the bullet because that = kinetic energy = degree of shock waves
What does blood/CSF from the nose or ears indicate?
Basal functure (fracture of the base of the skull)
