PassMedicine Flashcards
what are the types of traumatic brain injury
primary
secondary
what are the classifications of primary brain injury
focal (contusion/haematoma)
diffuse (diffuse axonal injury)
what is a contusion
ruptured capillaries AKA a bruise
what is a haematoma
a solid swelling of blood in the tissues
what types of intra-cranial haematomas
extradural haemorrhage
subdural haemorrhage
subarachnoid haemorrhage
how does secondary brain injury occur
when cerebral oedema, ischaemia, infection exacerbates original injury
what is a extradural haemorrhage
bleeding into space between the dura mater an skull
what are the common causes of extradural haemorrhage
acceleration-deceleration trauma
blow to side of head
where do the majority of extradural haemorrhages occur
temporal region due to fracture of skull rupturing middle meningeal artery
what is a subdural haemorrhage
bleeding into the outermost meningeal layer
between dura and arachnoid mater
where do subdural haemorrhages commonly occur
frontal and parietal lobes
what are the risk factors for subdural haemorrhage
age
alcoholism
anticoagulation
what are the features of subdural haeomorrhage
onset of symptoms slower than extradural haemorrhage
gradually increasing headache and confusion
what are the features of extradural haemorrhage
lucid interval (improvement in condition) followed by LOC
what is a subarachnoid haemorrhage
bleeding between arachnoid and pia mater
usually occurs spontaneously due to ruptured aneurysm
may be associated with head trauma
what are parietal lobe lesions associated with
sensory inattention ()
apraxias (inability to perform skilled movements)
inferior homonymous quadrantopia
what are occipital lobe lesions associated with
homonymous hemianopia cortical blindness (visual loss in normal looking eyes) visual agnosia (inability to recognise everyday objects)
what are temporal lobe lesions associated with
wernickes aphasia (this area forms the speech before sending it to brocas area) which results in word substitution but fluent speech
superior homonymous quadrantopia
auditory agnosia (inability to recognise everyday sounds)
prosopasgnosia (inability to recognise faces)
what is inferior homonymous quadrantanopia associated with
parietal lobe lesion
what is superior homonymous quadrantopia associated with
temporal lobe lesion
what is prosopagnosia (inability to recognise faces) associated with
temporal lobe lesion
what are frontal lobe lesions associated with
expressive (brocas) aphasia (located on posterior aspect of frontal lobe in the inferior frontal gyrus) with non-fluent, halting speech
disinhibition
anosmia (loss of smell)
inability to generate a list
what are cerebellum lesions associated with
midline lesions: gait + truncal ataxia
hemisphere lesions: intention tremor, past pointing, dysdiadokinesis
what area is affected in parkinsons disease
substantia nigra of basal ganglia
a dilated fixed pupil may indicate lesion to which CN
CNIII
uvula deviated away from side of lesion may indicate a lesion involving which CN
CNX
loss of the corneal reflex indicates lesion in which CN
CN VII
elderly, alcoholic,head injury, insidious onset of symptoms
most indicative of which intracranial haemorrhage
subdural haemorrhage
sensory inattention is associated with lesion in which lobe
parietal
which artery is associated with contralateral hemiparesis and sensory loss with the lower extremity being affected more than the upper
middle cerebral artery
which artery is associated with contralateral hemiparesis and sensory loss with the upper extremity being affected more than the lower
anterior cerebral artery
what dermatome responds to genitalia
S2, S3
what dermatome responds to the small toe
S1
what are common SEs of carbamazepine
P450 enzyme inducer
drownsiness + dizziness
SIADH
what does a lesion to the CN X cause
uvula deviated away from the side of the lesion
loss of gag reflex
what does a lesion to the CN IX cause
loss of taste (posterior 1/3 of the tongue)
