Intracranial hemorrhage us and central nervous system Trauma

Question 1

Commonest type of intracerebral hemorrhage are associated with this disease

Answer 1

systemic hypertension

Question 2

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

Answer 2

80% basal ganglia putamen

60% hypothalamus pons cerebellum

Question 3

Main population affected by intracerebral hemorrhage

Answer 3

People above 50 years old

Question 4

Why is there a bleeding in intracerebral hemorrhage

Answer 4

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

Question 5

Main cause of subarachnoid hemorrhage

Answer 5

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

Question 6

Other causes of subarachnoid hemorrhage

Answer 6

Bleeding diasthesis
Tumor
 trauma 
hypertension 
vasculitis 
no cause. 20%

Question 7

Do male and female have equally subarachnoid hemorrhage

Answer 7

Yes

Question 8

Main arterie causing subarachnoid hemorrhage

Answer 8

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

Question 9

Two forms of central nervous system trauma

Answer 9

Heads injury

spinal injury

Question 10

Two forms of head injury

Answer 10

Missile injury

non-missile injury

Question 11

Examples of myself injury of head injury

Answer 11

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

Question 12

Non-missile injury example

Answer 12

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

Question 13

Main reason of spinal injury

Answer 13

Compression due to main causes in head injury

Question 14

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

Answer 14

Laceration
bruising
Skull fracture
displaced fracture

Question 15

What are the different type of skull fracture

Answer 15

Fissure fracture
Depressed fracture
Contrecoup fractures
Growing fractures seen in infancy

Question 16

What is growing fracture

Answer 16

Brain tissue protrudes through fracture which prevents healing

Question 17

What is a displaced fracture

Answer 17

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

Question 18

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

Answer 18

Occipital

Question 19

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

Answer 19

Frontal

Question 20

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

Answer 20

Basal fractures

Question 21

What is cerebral contusion

Answer 21

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

Question 22

Types of cerebral contusions

Answer 22

Coup contusions
Contrecoup contusions
HERNIATION contusion

Question 23

Where does coup contusion appear

Answer 23

Site of impact

Question 24

3

Question 25

What is gliding contusion

Answer 25

Relative movement betweenParasagittal White matter and grey matter

Question 26

Are herniation contusion always due to coup

Answer 26

No Can be due to pressure

Question 27

Site of impacts of contrecoup contusions

Answer 27

On the diametrically opposite side

Question 28

What is diffuse axonal injury

Answer 28

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

Question 29

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

Answer 29

In gliding contusions

Question 30

Main parts of the brain affected by axonal injury

Answer 30

Brainstem | corpus callosum

Question 31

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

Answer 31

Axonal bulbs throughout white matter

Question 32

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

Answer 32

Soft granular lesions clusters of microglia

Question 33

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

Answer 33

Degeneration of longs tracts | shrunken cystic scars

Question 34

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

Answer 34

Diffuse axonal injury

Question 35

After head injury which condition is because of severe disability

Answer 35

Diffuse axonal injury

Question 36

Can you have concussion with mild form of diffuse axonal injury

Answer 36

Yes

Question 37

What events can lead to diffuse axonal injury

Answer 37

A fall from considerable Heights

Question 38

What is a concussion

Answer 38

Short lasting loss of consciousness

Question 39

What happened if there is death within minutes of head injury

Answer 39

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

Question 40

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

Answer 40

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

Question 41

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

Answer 41

Rupture of vertebral artery causing massive subarachnoid hemorrhage within posterior fossa

Question 42

What happens in injury of the neck

Answer 42

Dissection of internal carotid artery causing thrombosis and eventually cerebral infarction

Question 43

What types of injuries are possible at the parenchyma

Answer 43

``` Concussion contusions laceration diffuse axonal injury subarachnoid hemorrhages intraparenchymal hemorrhage is ```

Question 44

What is the consequence of the concussion in parenchymal injury

Answer 44

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

Question 45

What can cause a contusion of the parenchyma

Answer 45

Direct parenchymal injury from force ,vascular Disruption ,and edema

Question 46

What are the main susceptible sites to contusion in the parenchyma

Answer 46

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

Question 47

Type of head injury causing contusion to the parenchyma

Answer 47

Coup injury | Contre coup at opposite

Question 48

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

Answer 48

Different regions around corpus callosum paraventricular and hippocampus brainstem cerebral peduncle

Question 49

What secondary damage can occur after injury

Answer 49

Traumatic vascular injury with epidural subdural subarachnoid or intraparenchymal hemorrhages Epidural hematoma

Question 50

What type of fracture cause secondary damage

Answer 50

Skull fractures

Question 51

Main artery affected by secondary damage

Answer 51

Middle meningeal artery

Question 52

What are the different types of intracranial Hematoma

Answer 52

Extradural hematoma subdural hematoma intra-cerebral hematoma burst lobe

Question 53

Main cause of extradural hematoma

Answer 53

Complication of skull fracture

Question 54

Main artery involved in extradural hematoma

Answer 54

Middle meningeal artery

Question 55

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

Answer 55

Subdural hematoma

Question 56

person more at risk of chronic subdural hematoma

Answer 56

Elderly

Question 57

What is subdural hygroma

Answer 57

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

Question 58

Main cause of intracerebral hematoma

Answer 58

Contusions or basal ganglia hematoma

Question 59

What is a burst lobe

Answer 59

Combination of subdural hematoma ,cerebral contusion and intracerebral hematoma

Question 60

Consequence of intracranial hematoma

Answer 60

``` Siri edema brain swelling Brain damage if increased intracranial pressure Infection Fats embolism Brain damage if hypoxia ```

Question 61

Where does blood collect in subdural hematoma

Answer 61

Between inner surface of dura and outer surface of arachnoid

Question 62

In which patient is subdural hematoma common

Answer 62

Elderly patient with Atrophic brain minor trauma

Question 63

Which hemisphere does the bloods collect in subdural hematoma

Answer 63

Lateral hemisphere and may be bilateral

Question 64

Main cause of non-missile spinal injury

Answer 64

Subluxations and fracture /dislocation

Question 65

Missile cause of spinal injury

Answer 65

Bullets or missiles | Stab wounds