Pathology Flashcards
What are the possible consequences of concussion?
- Instantaneous loss of consciousness
- Temporary respiratory arrest
- Loss of reflexes
Which system is suggested to be involved in concussion?
Reticular activating system
How will the brain be affected by a penetrating injury compared to a closed injury?
Penetrating injury leads to direct disruption of tissue.
Closed injury leads to movement and compression of neural and vascular structures within the bony confines.
What are the potential secondary effects of traumatic injury to the brain?
Ischaemia
Hypoxia
Cerebral swelling (raised ICP)
Infection
Epilepsy
Why are skull fractures important to diagnose?
Because they are an indicator of a high energy transfer injury.
What determines if a skull fracture is open or closed?
If it communicates with the surface.
What is a comminuted fracture?
A fracture involving the splintering of bone.
What does blood/CSF from the nose and/or ears suggest?
Basal fracture
Which artery is most commonly associated with epi- and extra-dural haematomas?
Middle meningeal artery
Which vessels are most commonly associated with subdural haematomas?
Subdural veins
Why can an extradural haematoma rapidly kill?
When involving the middle meningeal artery, the high pressure of the artery means that blood will quickly extrude into the potential space between the dura and bone.
Pressure must be relieved or the patient will die.
Why are extradural haematomas particularly prevalent in the younger population?
Because the dura has not completely adhered to the skull
Why do subdural haematomas take longer to present?
Because it’s a lower pressure bleed situation involving the subdural veins.
Why are the elderly particularly susceptible to subdural haematomas?
Veins draining from the brain into venous sinuses in the dura become stretched as the brain gradually contracts with age, making them more susceptible to traumatic rupture.
What con contusions lead to?
Haemorrhagic necrosis
What is a coup injury?
The injury to the brain directly underlying the site of impact.
What is a contrecoup injury?
The injury to the side of the brain directly opposite the site of impact.
Where do stereotypic contusions tend to occur?
At the base of the brain (e.g. inferior frontal lobes, inferolateral temporal lobes)
What is likely to be present in a severe or multifocal brain injury?
A lot of sub-arachnoid haemorrhage.
What is likely to be present in a patient who has survived cerebral contusions?
Parts of the gyri will collapse and fold down.
With the passage of time, macrophages take away the damaged tissue and cerebral blood, leaving orange staining.
The brain doesn’t heal itself; it leaves an area of scarring and is a particularly distinctive injury, being at the tips of the gyri.
What is the difference between a contusion and a haematoma?
Haematoma is bleeding into the brain resulting in a pocket of blood, whereas a contusion is the soft tissue damage resulting in a bleed.
What is a laceration?
Penetration by a foreign body or skull fragments.
Which part of the brain is particularly susceptible to diffuse forms of brain injury?
Corpus collosum
What is diffuse axonal injury?
Injury resulting from traumatic brain injury from, for example, severe deceleration.
Instead of a focal site of damage, small blood vessels will have torn, resulting in damage to axons throughout the tracts of the brian.
