L16: Head Trauma Flashcards

1
Q

Mayo clinic mild head injury is:

  • Glasgow coma score: _______
  • Loss of consciousness: _________
  • Loss of consciousness: _________
  • No _______________
A

Mayo clinic mild head injury is:

  • Glasgow coma score: 13-15
  • Loss of consciousness < 30 mins
  • Loss of consciousness < 30 mins
  • No cerebral bleed (normal imaging)
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2
Q

Factors assessed by Glasgow coma scale?

A
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3
Q

Injury below red nucleus (________) => _________________

Injury above red nucleus (__________) => ______________

A

Injury below red nucleus (decerebrate), internal rotation of arms => all limbs extended

Injury above red nucleus (decorticate)=> arms flexed, legs extended

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4
Q

Epidural vs. Subdural Hematoma?

Radiological appearance?

A

Epidural: Lemon Shaped

Subdural: Banana Shaped

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5
Q

What artery is usually injured in an epidural hematoma?

A
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6
Q

What is the Monroe-Kellie Hypothesis?

A
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7
Q

What is used to check compensated/decompensated Intracranial Pressure?

A

Cushing Reflex: HYPERTENSION and BRADYCARDIA => trying to drive cerebral blood flow.
Increased intracranial pressure reduces cerebral perfusion, and the resultant cerebral ischemia causes massive sympathetic activation.

Look at optic disks!: Pappiloedma Present (>6 Hours raised ICP)

Sixth nerve palsy?: Lateral Recutus innervated by CNVI (abducens nerve). Check Abduction of the eye!

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8
Q
A
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9
Q

Significance of double blood supply from the Anterior Cerebral Artery?

A

Circle of Willis if blockage => Compensation

Perfectly symmetrical supply to both sides of the brain during development

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10
Q
A

Tonsil should not be more than 5mm below

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11
Q

Management of raised intracranial pressure?

A
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12
Q
A
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13
Q

Sign of Middle Cranial Fossa Injury?

Artery Involved?

A

Involves posterior auricular artery

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14
Q

Sign of Fracture of anterior cranial fossa?

A

Periorbital Ecchymosis

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15
Q

Sites for cerebrospinal fluid leakage?

A
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16
Q

What bone do we expect to be fractured when observing Cerebrospinal Fluid Otorrhoea?

A

Suspect Temporal Bone fracture

17
Q

What is this sign called? What do we expect the cause to be?

A

Hemotympanum: blood behind temporal membrane

Middle cranial fossa fracture (Battles sign commonly seen too)

18
Q

How do we determine if discharge is CSF?

A

Old test is presence of Glucose (glucose oxidase paper)

Better test is Beta2 transferrin located only in:

  • Cerebrospinal fluid
  • Perilymph
  • aqueous humour of eye
19
Q

At what Glasgow Score do we immediately Induce and intubate?

A

GCS <8 n=> Rapid sequence induction and intubation

Paralyze w/ neuromuscular blocker => Anesthetic => Intubate (Pressure on cricoid to compress esophagus)

20
Q

Common Problems after Head injury?

A

Post traumatic epilepsy after severe head injury

Endocrine dysfunction is often overlooked