Path III Flashcards
2 components of traumatic brain injury
impact
movement of brain in skull
types of skull fractures
depression
composed
hairline
subdural
rupture of bridging veins cause what
subdural bleed
crescent
cerebral a rupture cause what bleed
subarachnoid
most comon bleed on impact
epidural
middle meningeal is a branch of what
external carotid
sub dural bleeds are more common in what populations
older adults and infants because that subdural space is greater, greater tension on impact and brain has more room to move and get hurt
half moon hemorrhage
subdural
a chronic subdural bleed will appear what density on CT
hyper
hematocrit effect
subacute re bleeding into previous hemorrhaged areas
subdural hematoma
hygroma
chronic subdural hematoma
what type necrosis in chronic subdural hematoma
liquefactive
vertebral aa traverse what vertebrae
C6- C1
what occurs if laceration of basilar or vertebral a
acute bleed into subarachnoid space
= death
secondary problem of blood in subarachnoid space
toxic to other aa and cause vasopasms which dec perfusino more, Cx affected first
leakage of cell fluid cause edema
! uh oh
triad os shakey baby syndrome
encephalopathy
subdural hematomas
retinal hemorrhages
subdural hematomas in shakey baby syndrome locaed where
interhemispheric fissure usually
what occurs to brain and components in shakey baby syndrome
diffuse axonal injury from white matter strecthing
also eventually develop brain atrophy
what is a contusion
hemorrhagic necrosis of brain tissue
common contusion areas
orbital surfaces of frontal lobes and tips of temporal lobes
what is counter coup
contusions that develop opp impact because brain is whiplashed
what part of brain most prone to acceleration decelerations injuries
deep white matter
mod severe axonal injury can lead to what
wallerian degeneration
what is diffuse axonal injury
white matter/axons stretched
usually MVA or blows to unsupported head
what is used to measure DAI
beta amyloid precursor protein because will build up if cannot be transported down axon
common location DAI lesion
corpus callosum
stain for beta amyloid precursor protein
IHC stain
axonal swelling that is red
NOT red neuron
DAI
red neurons with spherules
red neurons
area of CNS subject to highest twisting force in sagittal roration of hemispheres
the upper brainstem
reticular system
cumulative concussions can cause
chronic traumatic encephalopathy
chronic traumatic encephlopathy
dementia
football players
tau stain
used for chronic traumatic encephalopathy because the tau protein collects on rim of Cx
role of tau
microtubule stabilization
tau fibrils also accumulate with what disease
alzheimers
high levels tau protein in CSF linked to what
poor recovery after head trauma
what are delayed neurological complications
seizures, infection, aneurysm, hydrocephalus swelling hematoma, increased pressure
subfalcin herniation is where and can cause what
the main falx herniates to a side
can compress anterior cerebral a
infarction
though this is rare
what is a central herniation and what can it cause
brain herniating down
VI compressed- lateral gaze palsy
b/l uncal herniation causing hemiparesis or full paresis
What is uncal transtentorial herniation
where uncus herniates into tentorium
signs uncal transtentorial herniation
3rd cranial nerve compromised- blown pupil
corticospinal tract- hemiplegia
could compress posterior cerebral a– primary visual Cx
What is tonsillar herniation
the tonsils herniate
signs tonsillar herniation
respiratory and cardiac effects
death
general Sx of inc intracranial P
HA altered mental status nausea vomiting papilledema visual loss diplopia cushings triad: HTN, bradycardia, irregular respirations
how does brain compensate for inc intracranial mass
reduce CSF and blood volume
Duret hemorrhage
pons and brainstem
small lineal bleeds
kernohans phenomenon
in uncal herniation where you get compression of posterior limb internal capsule
so ipsilateralhemiplegia from contralateral corticospinal compression
