Neuro: 17.5: Trauma Flashcards
How does a subdural hematoma present?
progressive neuro signs
Which artery is damaged in an epidural hematoma?
the middle meningeal artery
What is a lethal complication of an epidural hematoma?
transtentorial herniation
What is an uncal herniation? What is the result?
- uncus of temporal lobe under the tentorium cerebelli –>
- compress CN3 (down and out eyes with dilated pupil
- compress posterior cerebral artery (infarction of occipital lobe)
- pulls on paramedian artery of the brainstem (duret hemorrhages of the brainstem)
What brain injury is seen in shaken baby syndrome?
subdural hematoma
Dx?
- lucid interval of hours to days preceding neuro signs, then a rapid crash and possible herniation
an epidural hematoma
Name the herniation:
- uncus of temporal lobe under the tentorium cerebelli –>
- compress CN3 (down and out eyes with dilated pupil),
- compress posterior cerebral artery (infarction of occipital lobe)
- pull on paramedian artery of the brainstem (duret hemorrhages of the brainstem)
uncal
Name the herniation:
- cerebellar tonsils herniate thru the foramen magnum –> brainstem compression –> cardiopulmonary arrest
tonsillar
The middle meningeal artery is a branch of the _____.
maxillary artery
Dx?
- rupture of a bridging vein btw the dura and arachnoid –> bleed
a subdural hematoma
What is a subdural hematoma?
a collection of blood beneath the dura
What causes an epidural hematoma?
fracture of the temporal bone –> rupture of the middle meningeal artery
What does a subdural hematoma look like on CT?
- crescent-shaped blood collection that DOES cross suture lines
- can cause a midline shift
Name 2 predisposing factors to subdural hematoma.
- brain atrophy (age, EtOH, etc)
- trauma
What is a non-lethal complication of an epidural hematoma?
CN3 palsy
What are the 3 complications of an uncal herniation and their end result?
- compress CN3 (down and out eyes with dilated pupil)
- compress posterior cerebral artery (infarction of occipital lobe)
- pul on paramedian artery of the brainstem (duret hemorrhages of the brainstem)
What does an epidural hematoma look like on CT?
lens-shaped blood collection that DOES NOT cross suture lines
Name the herniation:
- cingulate gyrus under the falx cerebri –> compress the anterior cerebral artery –> infarction
subfalcine
What is a lethal complication of a subdural hematoma?
herniation
Dx?
- a collection of blood btw the dura and the skull
an epidural hematoma
What is an epidural hematoma?
a collection of blood btw the dura and the skull
What are the 3 most common types of brain herniation? Describe each.
- tonsillar (cerebellar tonsils thru the foramen magnum –> brainstem compression –> cardiopulmonary arrest)
- subfalcine (cingulate gyrus under the falx cerebri –> compress the anterior cerebral artery –> infarction)
- uncal (uncus of temporal lobe under the tentorium cerebelli –> compress CN3, compress posterior cerebral artery, and pulls on paramedian artery of the brainstem
What is a tonsillar herniation? What is the result?
- cerebellar tonsils herniate thru the foramen magnum –>
- brainstem compression –> cardiopulmonary arrest
What causes a subdural hematoma?
- rupture of a bridging vein btw the dura and arachnoid
- usu from trauma
What is a subfalcine herniation? What is the result?
- cingulate gyrus under the falx cerebri –>
- compresses the anterior cerebral artery –> infarction
Dx?
- a collection of blood beneath the dura
a subdural hematoma
Dx?
- a lens-shaped lesion on head CT
an epidural hematoma
