path - trauma/peds.congenital Flashcards
1. Describe the different patterns of intracranial hemorrhage, their mechanisms of development and their clinical presentation and significance: Subdural, Epidural, Contusion 2. Compare and contrast brain injury causes and patterns: Diffuse brain injury, Traumatic axonal injury, Concussion 3. Classify the congenital malformations based on the anatomic patterns and define the associated syndromes: Anencephaly, Dandy-Walker Malformation, Chiari malformation, Neural tube closure defects,
injury type where cerebral cell bodies are shrunken, stained red by eosin
acute hypoxic, ischemic
injury that shows as swelling of the neuronal cell body and peripheral dispersal of nissal substance
axonal injury
mechanical cause of a brain contusion
rapid tissue displacement, disruption of vascular channels and subsequent hemorrhage, tissue injury and edema
part of the the brain most suceptible to contusion
crests of the gyri
morphological evidence of brain contusion
nuclear pyknosis, cytoplasmic eosinophila, cellular disintegration
time for cellular changes in brain contusion
24 hours
signs of old brain contusions
depressed, retracted, yellow brown patches. gliosis and old
macrophages
mechanical cause of diffuse axonal injury
angular acceleration, even without impact
most common sites of diffuse axonal injury
near angles of lateral ventricles and brain stem
reversible altered conciousness from hed injury with lack of contusion
concussion
charecteristic neurological dysfcunction from concussion
loss of conciousness, temporary respiratory arrest and loss of reflexes
common vessel causing epidural hematoma
middle meningeal
common cause of epidural hematoma
skull fractures
clinical presentation of epidural hematoma
lucid at first, then sudden neurological decline
common cause of subdural hematoma
rapid movement of the brain during trauma tears bridging veins
why are elderly predisposed to subdural hematoma
in pts with brain atropy, bridging veins are more stretched out, leading to additional space for brain to move
clinical sx of subdural hematoma
can show within 48 hours, non localizing headache, confusion, slowly progressive neurological deterioration
maternal screening for _____ can be used for early detection of neural tube defects
alpha-fetoprotein
most common type of congenital CNS malformation
neural tube defects
neural tube defect most commonly found in lumbosacral region
myelomeningocele
neural tube malformation leading to the absence of the brain and top the skull
anencephaly
diverticulum od malformed CNS tissue extending through region of posterior fossa
encephalocele
small posterior fossa with misshapen midline cerebellum and diwnward extension of the vermis through the foramen magnum
arnold-chairi malformation
associated defects in arnold-chairi
hydrocephalus and lumber myelomeningocele
missing cerebellar tissue wih enlarged postier fossa, absence of vermis and latge midline cyst
dandy-walker
accumulation of excessive CSF within the ventricular system
hydrocephalus
most common mechanical cause of hydrocephalus
failure of resorption or impaired flow
noncommunication hydrocephalus cause
localized obstacle to CSF flow that causes only a portion of the ventricles to enlarge
site of most common blockage in noncommicating hydrocephalus
foramen of Monroe or mass conpressing cerebral aqueduct
characteristics of cerebral palsy
spasticity, dystonia, ataxia, athetosis, paresis
cause of cerebral palsy
injury occuring during pre/perinatal periods
major types of injury causing cerebral palsy
hemorrhage and infarct
large cystic lesions through the brain hemispheres in preinatal injury
multicystic encephalopathy
infarcts may occur in the supratentorial periventricular white matter
periventricular leukomalacia
