Macroscopic Effects of Trauma

Question 1

Unusual signs that might indicate a basal skull fracture?

Answer 1

Raccoon eyes, dark area around both eyes
A lot of force
Distant hematomas from the sight of trauma
(battle sign behind the ear)

Question 2

What is 2nd Impact syndrome?

Answer 2

A concussion patient gets a 2nd concussion before they recover from the first one.

Brain swells rapidly and can cause death

Question 3

Chronic Traumatic Encephalopathy

Answer 3

Degenerative Disease of the brain for athletes and those with repetitive trauma

Symptoms: Poor judgment, apathy, depression, mem loss, confusion, aggression
Progressive Dementia like Alz Dis.

Question 4

Direct parenchymal Injury is?

Answer 4

Direct injury to tissue

Question 5

What is a coup versus a contrcoup injury?

Answer 5

Coup injury (contusion at point of contact)
Contrecoup injury (contusion on opposite side)

Question 6

What is a diffuse axonal injury?

Answer 6

Injury of axons in deep white matter of brain

Twisting/shearing of axons
Caused by angular acceleration/deceleration
“Shaken baby” syndrome, boxing
Common cause of persistent deficits or coma after trauma

Question 7

A tear in the middle meningeal artery would cause what kind of heamtoma?

Answer 7

Epidural hematome

Question 8

What does an x-ray of an epidural hematoma look like?

Answer 8

The blood in the brain has smooth contours because the Dura is containing the blood

Question 9

Describe a very typical way that a subdural hematoma might occur?

Answer 9

An older patient (brain is smaller) falls down, but he seems okay

Shearing of bridging veins in the skull, can be acute or chronic

Question 10

What does an x-ray of an subdural hematoma look like?

Answer 10

ragged edges

blood is between the dura and arachnoid mater

Question 11

Subarachnoid Hemorrage is what exactly?

Answer 11

Blood is pouring into the arachnoid space
Can be caused by contusions or anyeurisms

Patients say: “Worst headache of my life!!!!!!”
Neuro emergnecy

Question 12

What does it mean when you say the skull fracture is depressed and comminuted?

Answer 12

Comminuted means: in pieces

Question 13

How do you grade concussions?

Answer 13

Grade 1: no loss of consciousness, lasts less than 15 minutes
Grade 2: No LOC, but longer than 15minutes
Grade 3: LOC

Symptoms: amnesia, confusion, headache, visual disturbances, nausea, vomiting, dizziness

Question 14

Common therapy for berry aneurism?

Answer 14

Using coils that are moved in place starting at the femoral artery