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COMAT - Surgery > Neuro > Flashcards

Neuro Flashcards

1
Q

List the 6 layers/spaces of the skull from outside to inside

A
  • Skull
  • Dura mater
  • Arachnoid mater
    – Subarachnoid space
  • Pia mater
  • Brain parenchyma
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2
Q

Between what layers do Epidural bleeds occur?

A

Skull and Dura mater

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3
Q

What is unique about Epidural bleeds?

A

They do NOT cross suture lines

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4
Q

How do Epidural bleeds arise?

A

Temporal bone fracture that lacerates the middle meningeal artery

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5
Q

Describe the patient presentation with an Epidural bleed

A
  1. Loss of consciousness
  2. Lucid (normal) interval
  3. Rapid DETERIORATION
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6
Q

What is the imaging choice for brain bleeds/trauma?

A

CT with NO CONTRAST

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7
Q

What is the imaging choice for brain bleeds/trauma? Contrast type?

A

CT with NO CONTRAST

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8
Q

How will an Epidural bleed look on CT?

A

Lens shaped – more spherical

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9
Q

Between what layers do Subdural bleeds occur?

A

Dura and Arachnoid mater

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10
Q

How do Subdural bleeds often occur?

A

Tearing of the bridging veins

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11
Q

In what patients are Subdural bleeds more common?

A

Older patients/alcoholics with atrophic brains

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12
Q

How will a Subdural bleed present?

A

Gradually worsening focal neuro deficit/altered mental status

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13
Q

How will a Subdural bleed look on CT?

A

Crescent shaped

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14
Q

What is the treatment for Epidural and Subdural bleeds?

A

Craniotomy/Craniectomy

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15
Q

Between what layers do Subarachnoid bleeds occur?

A

Arachnoid mater and Pia mater
– IN the Subarachnoid space

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16
Q

What is the most common cause of a Subarachnoid bleed?

A

Aneurysm

17
Q

How will a patient present with a Subarachnoid bleed?

A

“Thunderclap headache”
– Sudden onset to maximum intensity very FAST
+/- signs of meningitis

18
Q

How will a Subarachnoid bleed look on CT?

A

Bright white blood lining the gyri/sulci and basal cistern

19
Q

Will there be surrounding gray (vasogenic edema) with a Subarachnoid bleed?

A

NO

20
Q

If a Subarachnoid bleed is confirmed on CT, what test should be done next?

A

CTA to find the aneurysm

21
Q

If a CT is (-) but you are concerned for a Subarachnoid bleed, what test should be done next?

A

Lumbar puncture

22
Q

What often causes an Intraparenchymal Hematoma?

A

HTN related bleed in the lenticulostriate arteries

23
Q

How will the patient present with an Intraparenchymal Hematoma?

A

Focal neuro deficit that looks like a stroke

24
Q

How will an Intraparenchymal Hematoma look on CT?

A

Bright white blood in the brain that IS surrounded by dark gray (vasogenic edema)

25
Q

Will there be surrounding gray (vasogenic edema) with Intraparenchymal Hematomas?

A

YES

26
Q

Where are Basilar Skull fractures?

A

Base of skull or floor of face

27
Q

What are 3 signs of a Basilar skull fracture?

A

Battle sign (bruise behind ears)
Raccoon eyes (bruise around eyes)
CSF leaking from nose/ears

28
Q

What imaging (2) should be done when concerned for a Basilar skull fracture?

A

CT of the maxillary/facial region
CTA

29
Q

What defines a concussion/TBI?

A

Trauma that results in change in neurologic function

30
Q

How do concussions usually present?

A

Loss of consciousness +/- amnesia

31
Q

How will the CT look with a concussion?

A

Normal – rules out bleed

32
Q

Treatment for concussion?

A

Discharge and individual treatment plan

33
Q

If you see punctate hemorrhages on the front/back of the brain, what is that called?

A

Intraparenchymal contusions

34
Q

What causes Diffuse Axonal Injury?

A

Deceleration injury that shears the axons

35
Q

How will the CT look with a Diffuse Axonal Injury?

A

Normal at first

36
Q

The CT may be normal at first with a Diffuse Axonal Injury, however the patient will be?

A

Comatose usually

37
Q

After a few days following a Diffuse Axonal Injury, what imaging should be done?

A

MRI

38
Q

What is important to consider when medically treating Subarachnoid/Intraparenchymal bleeds?

A

Keep the BP LOW to prevent rebleeds/worsening of the bleed

COMAT - Surgery (13 decks)

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