Head Trauma - Cohen

Question 1

concussion

Answer 1

trauma associated with decline in LOC

Question 2

elderly

Answer 2

antiplatelet drugs - head trauma bad

Question 3

pathology of head trauma

Answer 3

initial impact
and acceleration/deceleration

also - pressure injuries

Question 4

head trauma

Answer 4

more in men

Question 5

glasgow coma scale

Answer 5

EVM

• eye 4
• verbal 5
• motor 6

Question 6

mild head trauma

Answer 6

minor - GCS 9-13

Question 7

moderate head trauma

Answer 7

GCS 8-12

Question 8

major head trauma

Answer 8

GCS <7

Question 9

lowest GCS

Answer 9

3 - dead person is 3

Question 10

components limiting volume of skull

Answer 10

brain
CSF
blood

Question 11

elevated pressure in skull

Answer 11

herniation can occur - deadly

Question 12

cushings reflex

Answer 12

sudden lesion of brain

-get HTN and bradycardia**

Question 13

traumatic SA hemorrhage

Answer 13

less worrisome than burst aneurysm

Question 14

cerebral contusion

Answer 14

small area of hemisphere bruised

more near brain surface from trauma

Question 15

epidural hematoma

Answer 15

fatal - need drained

Question 16

coutrecoup

Answer 16

injury opposite side of brain from the trauma

Question 17

subdural hematoma

Answer 17

venous blood
bridging veins

MC than epidural hematoma

elderly

Question 18

acute subdural hematoma

Answer 18

within 72 hours

Question 19

chronic subdural hematoma

Answer 19

21 days from suspected onset

Question 20

crescent shape on CT or MRI

Answer 20

subdural hematoma

Question 21

methemoglobin

Answer 21

Fe3+ - can’t bind O2

Question 22

drainage of subdural hematoma

Answer 22

clear deficits or over 3mm thickness

Question 23

large subdural hematoma

Answer 23

may grow - osmotic forces

Question 24

surgery for subdural

Answer 24

cohen thinks craniotomy better than drilling holes

Question 25

epidural hematoma

Answer 25

severe and life threatening

• tear middle meningeal artery
• higher pressure - arterial
• dural attachments limit spread of blood

Question 26

football shaped on CT and MRI

Answer 26

epidural hematoma

Question 27

lose consciousness in few hours

Answer 27

epidural hematoma

Question 28

lucid interval

Answer 28

severe head trauma with epidural hematoma

lose consciousness immediately - but then wake up

few hours later - will lose consciousness again

time between - lucid period

Question 29

epidural hematoma tx

Answer 29

burrhole near site of bleeding

Question 30

concussion

Answer 30

minor head injury

-head trauma with reversible decline in brain function

Question 31

clinical for concussion

Answer 31

need head CT immediately
-if pt loss of consciousness or persistent HA, or neuro deficit

symptom return, severe HA, vomiting - go to ER

Question 32

post concussive syndrome

Answer 32

persistent HA, light headed, depression, poor concentration, irritability - for weeks or months

hard to treat

Question 33

CTE

Answer 33

chronic traumatic encephalopathy

multiple minor head injuries - including concussion

boxers - punch drunk - dementia pugilistica

increased dementia in NFL players

Question 34

CTE histo

Answer 34

atrophy and tau deposition

tau is phosphorylated

also septum pellucidum and corpus callosum damaged