Lec 20: Traumatic Brain Injuries

Question 1

What is the leading cause of TBIs in the US?

Answer 1

falls

Question 2

Which sex is more likely to sustain a TBI?

Answer 2

male

Question 3

What are the two age groups at highest risk for TBI?

Answer 3

0 -4 y.o.: start of walking and increased activity

15- 19 y.o.: adolescence, increased risk-taking behavior

Question 4

What is the most common mechanism of injury for TBI?

Answer 4

acceleration-deceleration motion

Question 5

Why is a young child at greater risk for injurious acceleration-deceleration motion?

Answer 5

head is heavy in relation to the body so it moves more than should (shaken baby syndrome)

Question 6

Which types of TBIs would require actual contact to occur?

Answer 6

skull fracture and epidural hematoma

Question 7

What are the types of primary brain injury?

Answer 7

contusion, hematoma, concussion, diffuse axonal injury, laceration

Question 8

Which type of injury is the most damaging to the brain?

Answer 8

combination of translational, rotational, and angular movement

Question 9

What are the components of a primary brain injury?

Answer 9

nature of force, type of injury, magnitude/duration of impact

Question 10

What is the most potent prostaglandin?

Answer 10

thromboxane A2

Question 11

What are the criteria used in the Glasgow coma scale?

Answer 11

eye response, motor response, verbal response

Question 12

What are the usual locations of brain contusions?

Answer 12

frontal poles, orbital gyri, temporal poles

Question 13

What is the type of contusion with the worst outcome?

Answer 13

countercoup contusion

Question 14

What is the most common type of intracranial hematoma?

Answer 14

epidural hematoma

Question 15

Which artery is most commonly damaged in an epidural hematoma?

Answer 15

middle meningeal artery

Question 16

What is the hallmark of an epidural hematoma?

Answer 16

lucid interval

Question 17

What is the “classic triad” of EDH?

Answer 17

contralateral hemiparesis, dilatation of ipsilateral pupils, lucid interval

Question 18

Where do intracerebral hematomas usually occur?

Answer 18

frontal and temporal poles

Question 19

What is the most common etiology of a concussion?

Answer 19

twisting of brainstem

Question 20

What is pathognomonic for diffuse axonal injury?

Answer 20

axonal retraction balls

Question 21

What are the circulatory stages in severe TBI?

Answer 21

hypoperfusion, hyperemia, vasospasm

Question 22

A sub-falcine herniation results in?

Answer 22

leg weakness

Question 23

Central/Axial Herniation results in?

Answer 23

decreased sensorium/Cushing’s triad

Question 24

Posterior herniation results in?

Answer 24

bilateral ptosis/upward gaze paralysis

Question 25

Tonsillar herniation results in?

Answer 25

sudden apnea