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3 Neurology > Neurosurgery Module- Trauma and CSF > Flashcards

Neurosurgery Module- Trauma and CSF Flashcards

1
Q

what does the glasgow coma scale measure?

A

a patient’s level of consciousness in response to a stimulus

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2
Q

decorticate posturing indicates brain damage to where?

A

cerebrum
internal capsule
thalamus

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3
Q

what area is spared in decorticate posturing?

A

midbrain

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4
Q

what kind of posturing presents with arm flexion?

A

decorticate

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5
Q

what is the more severe out of decorticate and decerebrate posturing?

A

decerebrate

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6
Q

decerebrate posturing indicates brain damage to what area specifically?

A

area below the red nucleus in the midbrain

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7
Q

the reticulospinal tract causes flexion/extension

A

extension

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8
Q

the body is primarily in extension/flexion in decerebrate posturing

A

extension

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9
Q

total volume of CSF is…

A

150ml

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10
Q

how much CSF is produced daily?

A

450ml

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11
Q

why do you get ischaemia from increased CSF?

A

the increased ICP decreases cerebral blood flow physiologically

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12
Q

diplopia can be caused by what kind of herniation and why?

A

central herniation of the brainstem

can cause a CN6 palsy

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13
Q

an extradural haematoma is accumulation of blood between…

A

bone and dura

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14
Q

most common source of bleeding is from disruption of what artery?

A

middle meningeal

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15
Q

what common location for an EDH

A

temporoparietal region

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16
Q

young adult with closed head trauma who has loss of consciousness that quickly resolves followed by symptoms…

A

EDH

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17
Q

what symptoms present in EDH after consciousness is regained?

A

headache
N+V
contralateral hemiparesis
ipsilateral pupillary dilatation

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18
Q

why do pupils dilate in EDH

A

haematoma causes the uncus of the temporal lobe to herniate and compresses on the pupillary fibres of CN 3

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19
Q

imaging modality of choice in patients with head trauma?

A

CT head

20
Q

haematoma looks white/black on CT

A

white

21
Q

most SDH’s present __laterally in adults

A

uni

22
Q

bilateral SDHs are more common in…

why is this?

A

children

less adhesions in the subdural space

23
Q

how long does chronic SDH take to present?

A

3-7 weeks

24
Q

does EDH or SDH deteriorate faster? why?

A

EDH because arteries are there, SDH involves veins

25
Q

driving pathological factor for chronic SDH

A

brain atrophy causes veins to stretch and become easily ruptured which then causes an osmotic gradient

26
Q

acute SDH clinical features

A

SEVERELY decreased state of consciouscness

27
Q

PC of chronic haematoma

A

headache

confusion

28
Q

“crescent shaped hyperdensity on CT”

A

acute SDH

29
Q

“crescent shaped hypodensity o nCT”

A

chronic SDH

30
Q

name the triad of symptoms in normal pressure hydrocephalus

A
  1. shuffling gait
    dementia
    incontinence
31
Q

how do communicating and non-communicating hydrocephalus differ?

A

communicating is enlargement of the ventricular system with NO obstruction of flow whereas non-communicating does

32
Q

how could you tell on imaging if the hydrocephalus is communicating or non-communicating?

A

if the 4th ventricle is small in comparison to the other ventricles -> non-comm

33
Q

congenital hydrocephalus is mainly due to what condition?

A

aqueductal stenosis

34
Q

“cracked pot sound on head percussion”

A

congenital hydrocephalus

35
Q

there is impaired _gaze in hydrocephalus

A

upgaze

36
Q

hydrocephalys history q’s?

A

antenatal and birth history
milestones
ICP symptoms
recent trauma/infection

37
Q

when should you do a CT and MRI in hydrocephalus?

A

CT best for acute scenario to confirm diagnosis

MRI for cause and site of obstruction

38
Q

chiari malformations are located in what area of the brain?

A

hindbrain

39
Q

most common chiari malformation?

A

chiari 1 malformation

40
Q

associated conditions along with a chiari 1 malformation?

A

syringomyelia

41
Q

what is the patients headache like in a chiari 1 malformation?

A

headache worse on coughing and neck extension with sub-occipital pain

42
Q

“cape-like sensory loss of pain and temperature”…

A

syringomyelia

43
Q

which chiari malformation is more severe?

A

chiari 2

44
Q

chiari 2 malformations are related to what condition?

A

spina bifida

45
Q

Tx of chiari malformations?

A

surgery for decompression

46
Q

what is the headache like in IIH?

A

throbbing, worse in morning, relieved on standing

47
Q

“slit-like ventricles”

A

IIH

3 Neurology (41 decks)

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