Miscellaneous Neuro

Question 1

Epidural vs. Subdural vs. Subarachnoid

Answer 1

Epidural: MMA, lucid interval, CNIII palsy, death in 2-12 hours makes it an acute medical emergency. lens shaped CT. no crossing sutures, but may cross midline

Subdural: bridging veins. bloody BSF, common in infants, elderly, alcoholics, etc. Crescent shaped CT. can have acute or chronic. May cross sutures, does not cross midline

IMAGING of SUBDURAL: 1-3 days hyperdense, 4 days-3weeks isodense >3 weeks - hypodense

Subarachnoid: berry aneurysm. worst headache of my life. bloody or yellow spinal tap. blood in cisterns on CT.

Question 2

Diffuse Axonal Injury is the most common cause of?

is a major cause of?

Answer 2

DIffuse Axonal Injury:

Major cause of prolonged traumatic coma

Most common cause of poor neurological outcome

Question 3

Describe a typical contusion

Answer 3

• wedge shaped lesion with base at pia, apex toward white matter
• over time, goes from bright red to brick red to golden brown covered with a floor of glial tissue and leptomeningeal fibrosis

Question 4

what causes post-traumatic epilepsy?

Answer 4

dura-arachnoidal adhesions that form post-contusion/trauma