Neuro trauma Flashcards
Hemorrhage in medulla/pons in someone with a subdural (or other mass effect). Why would this happen
Duret hemorrhage form uncal herniation
Two types of temporal bone fracture, Which is more common.
Fracture through what part is most prognostic?
- describe things that occur more commonly w/ longitunial fractures, vs. transverse fractures
Longitudinal (more common), Transverse (less common.
Otic capsule (more likely facial nerve injury, SNHL, or CSF leak)
Longitudinal fracture; more ossicular dislocation, more conductive hearing loss
Transverse fracture; more vascular injury, more sensorineural hearing loss
Brain blood on MRI mneumonic (or draw out the visual memory aid)
I Be IDdy BiDdy BaBy DooDoo
What is most sensitive MRI sequence for SAH?
Flair
DAI (grading system)
Deep subcortical Wm, posterior corpus callosum and basal ganglia. Initial head CT frequently negative.
Grade 1; grey-white
grade 2; Posterior CC
Grade 3: BG (dorsolateral midbrain)
Mucocele buzzowrd
Airless expanded sinus.
T1 bright w/ thin rim of enhancement. Frontal sinus is most common location.
Pulsatile exophthalmos is a buzzword for what?
Carotic cavernous fistula
Direct: trauma leads to communication b/w cavernous sinus and intracavernous ICA
Indirect: Random post-menoupausal women, cavernous sinus communicataes with meningeal branches of EXTERNAL carotid artery
Leforte fractures - all involve pterygoid process
1; floating palate (horizontal fracture), lateral nasal aperture
2; floating maxilla (pyramidal fracture), inferior orbital rim/floor
3; floating face, zygomatic arch, lateral orbital rim/floor.
4 types of extra-axial hemorrhage
SAH, SDH, EDH, intraventricular hemorrhage.
Subarachanoid hemorrhage - most common causes, and location of SAH in trauma
trauma is MCC of SAH. Aneurysm rupture is MCC of non-traumatic SAH.
Traumatic SAH is contralateral to side of impact, usually superficial cerebral sulci.
Epidural hematoma: classically a fracture of __ portion of temporal bone, causing __ artery tear.
What is swirl sign.
Venous epidural is much less common, but when may this occur?
Squamous part of temporal, causing meningeal artery tear.
Swirl sign is mixed high and low attenuation in active bleed.
Venous epidural can occur in laceration of dural sinuses, usually in posterior fossa of a kid
Subdural hematoma; crescentic, doesn’t cross midline, results from tearing of bridging veins.
what is the danger of subdural hematoma and ventricular shunt
A subdural with ventricular shung is dangerous because ventricular system won’t act as a tamponade
Intraventricular hemorrhage occurs due to what?
tearing of subependymal veins or direct extension of subarachanoid or intraparenchymal hematoma.
3 types of intra-axial injury
DAI/TAI, cortical contusion, intraparenchymal hematoma.
Cortical contusion occurs due to counter coup and effects gyral crests.
subacute contusion appearance on MR?
Chronic contusion on CT or MR.
subacute contusion is ring enhancing
chronic contusion appears like encephalomalacia on CT. MR shows peripheral hemosiderin deposion as hypointense on T2 and blooming artifact on GRE.
