lecture 12 - traumatic brain injury Flashcards
What are the 3 types of haemorrhage caused by a traumatic brain injury/
Epidural hematoma, subdural hematoma, subarachnoid haemorrhage
Which artery is usually implicated in an epidural hematoma?
Middle Meningeal artery
What type of injury typically causes an epidural hematoma?
Trauma to the side of the head resulting in temporal bone fracture and a tear of the MMA
What are the CT scan findings in an epidural hematoma?
Biconvex hyperdense mass stopping at suture lines, with midline shift, ipsilateral ventricular compressions
What is key change over time in the appearance of an (untreated) epidural hematoma)?
Reducing hyperdensitiy of the biconves disc
What is the early clinical presentation of an epidural hematoma?
An initial period of lucidity before a rapid loss of consciousness after several hours
What are the symptoms of an epidural hematoma?
Signs of acutely raised ICP: fixed pupils, facial weakness, coma, etc.
What is the typical cause of a subdural hematoma?
Rupture to the bridging veins that run through the subdural space to the dural sinuses
Why are elderly patients at increased risk of subdural hematoma?
Cerebral atrophy puts increased traction of bridging veins, predisposing them to rupture
What are the CT scan findings in a subdural hematoma?
Sickle/crescent shaped hyperdensity (darkens with time), with midline shift and ipsilateral ventricular compression
What are the symptoms of subdural hematoma?
Symptoms of raised ICP: fixed pupils, facial weakness, headache, loss of consciousness
What are the 2 main causes of subarachnoid haemorrhage?
Trauma, rupture of a cerebral aneurysm (spontaneous SAH)
What is the cause of a spontaneous SAH?
rupture of a berry aneurysm in the circle of Willis
What is the first symptom of a subarachnoid haemorrhage?
Thunderclap headache
What are the findings on CT in a subarachnoid haemorrhage?
Hyper density in the basilar cisterns (dancing man sign), hyperdensity in pericallosal cistern (sagittal CT), hyper-density in sulci
