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Hugh's MD1 Neuro > Head trauma and spinal injury > Flashcards

Head trauma and spinal injury Flashcards

1
Q

Where does traumatic axonal injury most commonly appear?

A

The corpus callosum

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1
Q

Is grey or white matter predominantly affected in vasogenic cerebral oedema?

A

White matter

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1
Q

Which type of cerebral oedema is responsive to steroid treatment?

A

Vasogenic

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2
Q

What is the volume of CSF?

A

150mL

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3
Q

What is a cause of chronic traumatic encephalopathy?

A

Repeated traumatic injury to the brain eg in boxers

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3
Q

What occurs if rising ICP can’t be compensated for?

A

There is herniation of brain hemisphere through dural openings

Brain perfusion can cease if ICP overtakes cerebral perfusion pressure (CPP)

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3
Q

What is vasogenic cerebral oedema caused by?

A

Blood-brain barrier disruption due to increased vascular permeability

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4
Q

What is a concussion characterised by?

A

Temporary lose of consciousness, respiratory arrest and reflexes

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5
Q

What are contusions?

A

Haemorrhagic necrosis in the brain

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6
Q

Can subdural bleeds cause raised ICP?

A

Yes

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7
Q

What are the longterm effects of diffuse axonal injury?

A

Brain atropy

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8
Q

What are some non-acute effects of traumatic injury?

A

Infection

Epilepsy

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10
Q

What are some acute secondary effects of traumatic injury?

A

Hypoxia

Ischaemia

Raised ICP

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12
Q

How much does the scalp bleed?

A

A lot

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13
Q

What is a common cause of concussion?

A

Rapid change of momentum of the brain

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14
Q

What is it called when skull fractures have splintering of bone?

A

Comminuted

15
Q

What symptom is characteristic of subarachnoid bleeds?

A

A thunderclap headache

15
Q

What is chronic traumatic encephalopathy characteristed by?

A

Brain atropy due to neuronal lose

Abnormal deposition of Tau protein

Often deposition of A-beta plaques in the cortex

17
Q

When do subarachnoid haemorrhages generally occur?

A

Aneurysms following trauma

18
Q

How do old cerebral contusions appear?

A

Drooping of brain tissue along gyri and deposition of orange tissue - indicative of healing by macrophages and scarring

18
Q

What is hydrocephalus?

A

Dilation of the ventricles due to interruption of CSF flow - brain is damaged as a result

21
Q

Diffuse vascular injury affects which vessels?

A

V. small vessels

22
Q

Is grey or white matter affect in cytotoxic cerebral oedema?

A

Both

23
Q

Subdural haemorrhages are more common in which age group? Why?

A

The elderly because atropy of the brain tends to greater tension on the subdural veins making them more likely to tear

25
Q

Why are contusions on the base of the brain common?

A

Protuding, boney structures can be rubbed against

26
Q

In which age group are epidural bleeds less likely? Why?

A

The elderly because their dura adheres more strongly to the skull

27
Q

How does an atropied brain appear?

A

Enlarged ventricles

Thin corpus callosum

White matter is generally thinner

28
Q

What is a contrecoup?

A

When the brain bounces against the back wall of the skull resulting in injury to both sides of the brain

29
Q

What are the compensations for rising ICP?

A

Ventricles shrink

Gyri flatten out

Blood is forced out

30
Q

What is cytotoxic cerebral oedema caused by?

A

Increased intracellular fluid secondary to neuronal, glial, or endothelial cell injury

31
Q

What are common site for contusions on the base of the brain?

A

Inferior frontal lobe (eg olfactory bulbs)

Inferiorlateral temporal lobe

32
Q

Subdural haemorrhage are due to damage to which vessels?

A

Subdural veins eg the superior cerebral veins

33
Q

What determines the damage done by a bullet?

A

The velocity of the bullet because that = kinetic energy = degree of shock waves

34
Q

What does blood/CSF from the nose or ears indicate?

A

Basal functure (fracture of the base of the skull)

Hugh's MD1 Neuro (41 decks)

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