Neuro Basics Flashcards
Middle Meningeal Artery
Associated with epidural hematoma
Middle Meningeal Artery
a
Epidural Hematoma
a
Subdural Hematoma
a
Subarachnoid Hemorrhage
a
Intraparenchymal Hemorrhage
a
Blunt Trauma
a
Sharp Traums
a
Closed head injury
a
Penetrating (open) head injury
S
Skull Fracture
a
Concussion
s
COntusion
a
Laceration
a
Coup Injury
k
Diffuse axonal injury
a
What type of trauma will result in significant loss of CNS function or death?
Closed
Open
Blunt
Sharp
What three factors contribute to damage of the CNS?
Nature of injury (blunt vs. sharp)
Severity (force)
SItuation/DIrection of blow
What are the supporter cells of the CNS?
Astrocytes
What are oligodendroglia?
Myleniating cells of CNS (Schwann in periphery)
- Oligos: Many cells
- Schwann: One neuron
What are Ependymal cells?
Lining of ventricles, make CSF
What are microglia?
The macrophages of the CNS
What are inclusion bodies specific for?
Neurodegeneration
Where are Lewy bodies found?
Parkinson’s patients
Where are neurofibrillary tangles seen?
Alzheimer’s disease
What are some subcellular alterations?
Lipofuscin (aging) Viral Inclusions (HSV)
What happens in cellular injury of a neuron outside the cell body?
Axonal degeneration (regeneration)
What are some glial reactions to injury?
Astrocytes: GLIOSIS, Rosenthal fibers (thick eosinophilic bundle)
Oligos: Demyelination (remyelination)
Microglia: Proliferate (form rod cells)
- Neuronophagia
- Phagocytic functions
What is neuronophagia?
Congregation of microgila around dying neurons
What causes cerebral edema?
Trauma
Hypoxia/ischemia
Infection
Neoplasm
Vasogenic: Leakage of BBB (HTN, Trauma)
Cytotoxic: Intracelluular fluid leak (due to ischemic)
Where is CSF reabsorbed?
Arachnoid Granulation
- Ventricles-3rd ventricle-Cerebral aqueduct-4th vent-Foramen of magendie (medial)/Foramen of Lushka (lat)-Arachnoid space-flow through SC-Back to top of brian-reabsorbed by arachnoid granulation
What is non communicating hydrocephalus?
Obstruction w/i ventricles FOCAL ENLARGEMENT (proximal to obstruction)
What is communicating hydrocephalus?
Obstruction outside ventricular system
ENLARGEMENT OF ENTIRE SYSTEM
What is hydrocephalus ex vacuo?
Dilation of vent system due to atrophy (alzheimers, huntingtons)
What is the consequence of a bony vault for skull?
Expanding lesions lead to increased increased intracranial pressure that may lead to impingement on important structures of herniation of brain to brainstem BAD
What are some etiologies of increased intracranial pressure?
Abscess Tumor Edema Hemorrhage Hydrocephalus
What are some etiologies of increased intracranial pressure?
Abscess Tumor Edema Hemorrhage Hydrocephalus
What are some consequences of increased intracranial pressures?
Papilledema
Brain Herniation (cingulate gyrus, uncal)
Decreased BF
What will you see with uncal herniation?
Dilated pupils due to compression of 3rd nerve
Duret Hemorrhages (brain stem)
Compress PCA: Bilateral homonymous with macular sparing
What happens in cingulate herniation?
SUBFALCINE
Compress ACA: infarction
What happens in Tonsillar herniation (foramen magnum)?
Compress brain stem
Decrease blood flow
What happens in Tonsillar herniation (foramen magnum)?
Compress brain stem
Decrease blood flow
What is the nature of skull fractures?
Most do not cross the sutures: MONOSTATIC
What happens in distatic fractures?
The fracture crosses the suture (Extreme force)
What are signs of basilar skull fracture?
Orbital hemorrhage (racoon sign) Mastoid hemorrhage (battle's sign) Cranial nerve injury CSF leakage through nose/ears Meningitis
What are depressed skull fractures?
Displaced fracture edges greater than thickness of bone
What type of injury causes basal skull fractures?
Impact to occiput/sides of head
What are some types of vascular injuries in the brain?
Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
What are epidural hematomas?
Arterial source
Rapidly accumulate
Medical emergency
Fracture might rupture middle meningeal artery
Can cause herniation/compression
Get pupil dilation due to compressed 3rd nerve
Upper Motor neuron signs
What are subdural hematomas?
Venous source
SLOWLY accumulate
What are subarachnoid hemorrhage?
Associated with contusions
What are some parenchymal injurys?
Concussion
CONtusion/laceration
Coup/contrecoup injury
DIffuse axonal injury
What is a concussion?
Temporary loss of conciousness due to head injury
What do you see in contusions?
Bruse of the brain
Ring and Ball hemorrhage
Along perivascular space
What causes diffuse axonal injury?
Often rotational acceleration/deceleration injury
Creates shear forces on brain
What causes neurologic dysfunction in a spinal cord injury?
Injury of white matter tracts, not the local damage itself
Epidural Hematoma
Does not cross the suture lines
Can have compression signs (dilated pupil)
Medical Emergency
Subdural Hematoma
Associated with blunt trauma
Develop slowly but can cause herniation
Subarachnoid Hemorrhage
Worse headache of your life
Intraparenchymal Hemorrhage
Can progress to subarachnoid hemorrhage
Blunt Trauma
a
Diffuse axonal injury
Associated with shear force due to acc/decel forces
