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Neurology > Intracranial hemorrhage us and central nervous system Trauma > Flashcards

Intracranial hemorrhage us and central nervous system Trauma Flashcards

1
Q

Commonest type of intracerebral hemorrhage are associated with this disease

A

systemic hypertension

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2
Q

Main part of the brain affected by intracerebral hemorrhage due to systemic hypertension

A

80% basal ganglia putamen

60% hypothalamus pons cerebellum

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3
Q

Main population affected by intracerebral hemorrhage

A

People above 50 years old

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4
Q

Why is there a bleeding in intracerebral hemorrhage

A

MicroAneurysm Charcot Bouchard develop in penetrating branches coming from arteries at 90° and they may rupture into the ventricle and extend into subarachnoid space

Fibrinoid necrosis

Hyaline arteriosclerosis

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5
Q

Main cause of subarachnoid hemorrhage

A

Rupture of saccular berry aneurysm in circle of Willis. 40 to 65%

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6
Q

Other causes of subarachnoid hemorrhage

A 
Bleeding diasthesis
Tumor
 trauma 
hypertension 
vasculitis 
no cause. 20%
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7
Q

Do male and female have equally subarachnoid hemorrhage

A

Yes

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8
Q

Main arterie causing subarachnoid hemorrhage

A

Middle cerebral Artery 54 %
anterior artery 40%
basilar artery 4%

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9
Q

Two forms of central nervous system trauma

A

Heads injury

spinal injury

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10
Q

Two forms of head injury

A

Missile injury

non-missile injury

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11
Q

Examples of myself injury of head injury

A

Objects propelled through the air which enter cranial cavity causing focal damage
can be slow velocity missile or high velocity missile

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12
Q

Non-missile injury example

A

Sudden deceleration or acceleration of head which makes brain moves within cranial cavity
so damage of bony prominences and shear strain within the brain

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13
Q

Main reason of spinal injury

A

Compression due to main causes in head injury

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14
Q

What are the different types of legends of the scalp and skull

A

Laceration
bruising
Skull fracture
displaced fracture

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15
Q

What are the different type of skull fracture

A

Fissure fracture
Depressed fracture
Contrecoup fractures
Growing fractures seen in infancy

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16
Q

What is growing fracture

A

Brain tissue protrudes through fracture which prevents healing

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17
Q

What is a displaced fracture

A

fracture end displaced into cranial cavity more than thickness of the bone

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18
Q

If you are a wide awake which part of your skull is most at risk for fracture

A

Occipital

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19
Q

If you are in town choose which part of the skull is more at risk of fracture

A

Frontal

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20
Q

If you fall on the side which type of fracture are you most at risk to get

A

Basal fractures

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21
Q

What is cerebral contusion

A

Bruises of the brain generally due to strong blow to the head

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22
Q

Types of cerebral contusions

A

Coup contusions
Contrecoup contusions
HERNIATION contusion

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23
Q

Where does coup contusion appear

A

Site of impact

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24
Q

3

A
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25
Q

What is gliding contusion

A

Relative movement betweenParasagittal White matter and grey matter

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26
Q

Are herniation contusion always due to coup

A

No Can be due to pressure

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27
Q

Site of impacts of contrecoup contusions

A

On the diametrically opposite side

28
Q

What is diffuse axonal injury

A

Widespread disruption of axons do you to shear and tensile strains at time of acceleration and deceleration

29
Q

U Which form of contusion do you have increased incidence of diffuse axonal injury

A

In gliding contusions

30
Q

Main parts of the brain affected by axonal injury

A

Brainstem

corpus callosum

31
Q

What do you find in the brain of someone that survived for days to diffuse axonal injury

A

Axonal bulbs throughout white matter

32
Q

Where do you find in the brain of someone that survived for weeks adiffuse axonal injury

A

Soft granular lesions clusters of microglia

33
Q

What do you think in the brain of someone that survived for months a diffuse axonal injury

A

Degeneration of longs tracts

shrunken cystic scars

34
Q

What is the common is cause of Cormel in the absence of intracranial hematoma

A

Diffuse axonal injury

35
Q

After head injury which condition is because of severe disability

A

Diffuse axonal injury

36
Q

Can you have concussion with mild form of diffuse axonal injury

A

Yes

37
Q

What events can lead to diffuse axonal injury

A

A fall from considerable Heights

38
Q

What is a concussion

A

Short lasting loss of consciousness

39
Q

What happened if there is death within minutes of head injury

A

Multiple petechial hemorrhages in hemisphere especially white matter of frontal temporal lobes in brainstem

40
Q

What structures are teared if there is tearing in the brainstem at the Ponto medullary Junction due to head injury

A

cranial nerves
Cavernous part of internal carotid causing cavernous fistula formed
pituitary stalk with infarction of anterior lobe

41
Q

What happens if there’s a blow in the upper neck below the ear

A

Rupture of vertebral artery causing massive subarachnoid hemorrhage within posterior fossa

42
Q

What happens in injury of the neck

A

Dissection of internal carotid artery causing thrombosis and eventually cerebral infarction

43
Q

What types of injuries are possible at the parenchyma

A 
Concussion
 contusions 
laceration 
diffuse axonal injury 
subarachnoid hemorrhages
 intraparenchymal hemorrhage is
44
Q

What is the consequence of the concussion in parenchymal injury

A

Alteration in consciousness
transient neurological dysfunction
loss of consciousness and reflexes
Recovery follows but amnesia and other neuropsychiatric disorders may occur

45
Q

What can cause a contusion of the parenchyma

A

Direct parenchymal injury from force ,vascular Disruption ,and edema

46
Q

What are the main susceptible sites to contusion in the parenchyma

A

Crest of gyri

direct impact to rough bony surfaces, frontal lobe, orbital gyri, Temporal lobes , along fracture ends

47
Q

Type of head injury causing contusion to the parenchyma

A

Coup injury

Contre coup at opposite

48
Q

Which part of the brain the Parenchyma are affected by diffuse axonal injury

A

Different regions around corpus callosum
paraventricular and hippocampus
brainstem
cerebral peduncle

49
Q

What secondary damage can occur after injury

A

Traumatic vascular injury with epidural subdural subarachnoid or intraparenchymal hemorrhages

Epidural hematoma

50
Q

What type of fracture cause secondary damage

A

Skull fractures

51
Q

Main artery affected by secondary damage

A

Middle meningeal artery

52
Q

What are the different types of intracranial Hematoma

A

Extradural hematoma
subdural hematoma
intra-cerebral hematoma
burst lobe

53
Q

Main cause of extradural hematoma

A

Complication of skull fracture

54
Q

Main artery involved in extradural hematoma

A

Middle meningeal artery

55
Q

Which type of hematoma do you have in small amounts after any head injury

A

Subdural hematoma

56
Q

person more at risk of chronic subdural hematoma

A

Elderly

57
Q

What is subdural hygroma

A

Collection of cerebrospinal fluid without blood under dura which are mostly derived from chronic subdural hematoma’s
Seen mostly in elderly after minor trauma or children after infection

58
Q

Main cause of intracerebral hematoma

A

Contusions or basal ganglia hematoma

59
Q

What is a burst lobe

A

Combination of subdural hematoma ,cerebral contusion and intracerebral hematoma

60
Q

Consequence of intracranial hematoma

A 
Siri edema 
brain swelling
Brain damage if increased intracranial pressure
Infection
Fats embolism
Brain damage if hypoxia
61
Q

Where does blood collect in subdural hematoma

A

Between inner surface of dura and outer surface of arachnoid

62
Q

In which patient is subdural hematoma common

A

Elderly patient with Atrophic brain minor trauma

63
Q

Which hemisphere does the bloods collect in subdural hematoma

A

Lateral hemisphere and may be bilateral

64
Q

Main cause of non-missile spinal injury

A

Subluxations and fracture /dislocation

65
Q

Missile cause of spinal injury

A

Bullets or missiles

Stab wounds

Neurology (31 decks)

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