Head Trauma, Cohen

Question 1

population affected most by head trauma

Answer 1

men

elderly now on medications like anti platelet anti coagulation

Question 2

general injury causing head trauma

Answer 2

acceleration deceleration
strike by object
cerebral edema

Question 3

Minor head trauma
moderate
severe

Answer 3

minor is 9-13 on glascow scale

mod: 8-12
major: <7

Question 4

components of glascow scale

Answer 4

eye movement 4
verbal response5
motor response 6

Question 5

Volume of skull limited by

Answer 5

brain
CSF
blood in aa and vv

Question 6

Cushing reflex

Answer 6

hypertension and bradycardia

Question 7

most dangerous traumatic hemorrhage in brain

Answer 7

ruptured aneurysms

Question 8

contusions

Answer 8

small ares bleeding in brain itself

usually near surface sometimes deeper

Question 9

type of bleed from tearing of bridging veins

Answer 9

subdrual hematoma

Question 10

subdurals more common in who

Answer 10

elderly with more room between brain and skull

Question 11

acute vs chronic subdural hematoma

Answer 11

chronic is seen 21 days since onset

acute if within 72 hours

Question 12

Sx subdural hematoma

Answer 12

HA
confusion
hemiparesis
seizures
CN III palsies

Question 13

CT MRI subdural hematoma

Answer 13

crescent

Question 14

Tx if patient has clear deficits and subdural is over 3 mm thick

Answer 14

surgical drainage

small burr holes or full craniotomy

Question 15

do all subdural hematomas shrink

Answer 15

some can expand and soon deteriorate

Question 16

what causes delayed hydrocephalus

Answer 16

loss of CSF earlier

Question 17

epidural hematoma

Answer 17

dangerous!!
can have skull fracture
middle meningeal tear
compress brain more quickly

Question 18

Hx epidural hematoma

Answer 18

suffered serious injury with loss of consciousness immediately

Question 19

Lucid interval

Answer 19

lost consciousness wake up then lose again

time between is lucid interaval

Question 20

lens shape bleed

Answer 20

epidural

Question 21

Tx epidural

Answer 21

surgical drainage!!

Question 22

Concussion

Answer 22

head trauma producing reversible decline in brain function even without loss of consciousness

Question 23

Head CT for concussion

Answer 23

when loss of consciousness, persistent HA or significant neurological deficit

Question 24

Post concussive syndrome

Answer 24

persistent HA
light headedness
depression
poor concentration
irritability

Question 25

chronic traumatic encephalopathy

Answer 25

irreversible brain disease from multiple minor head injuries like concussions
Tau aggregation along Cx
atrophy widened sulci and large ventricles
septum pellucidum and corpus callosum damaged

Question 26

early Sx CTE

Answer 26

irritability, anger, aggression, impulses, memory loss and inattention
lack of insignt, inability to manage affairs, loss of language skills
frontotemporal dementia
looks like PD or ALS