Pathology of head injury

Question 1

Why can something extra added into the space within the skull lead to an increased ICP?

Answer 1

the skull does not have distensibility

Question 2

5 basic injury types

Answer 2

bruise 
abrasion 
laceration 
incision 
thermal injuries

Question 3

What is a contusion?

Answer 3

bruise

Question 4

What causes bruising?

Answer 4

blunt force on the skin which damages little blood vessels and the blood oozes on to tissues

Question 5

When located where are bruises likely to have a pattern?

Answer 5

deep dermis layer

Question 6

What are black eyes a form of?

Answer 6

bruises

periorbital contusion

Question 7

How do black eyes occur?

Answer 7

blood tracts from injury site under loose tissues and collects

Question 8

What is the likely cause of 2 black eyes?

Answer 8

injury further up in the head eg deep skull head injury

Question 9

What is an abrasion?

Answer 9

Injury to superficial part of the skin which may bleed, dry and scab

Question 10

Why do abrasions not scar?

Answer 10

Deep layers unaffected

Question 11

What is an incision due to and how is it fixed?

Answer 11

sharp force eg knife

stitches

Question 12

What is a laceration and what causes it?

Answer 12

tear/split in the skin caused by an application of injury and is usually blunt force eg hammer

Question 13

Where does a laceration split?

Answer 13

weakest point

Question 14

Do incisions or lacerations have a worse cosmetic prognosis?

Answer 14

lacerations

Question 15

Name the 4 types of fractures

Answer 15

ring
hairline
depressed
fissure

Question 16

What happens in ring fractures?

Answer 16

very big energy injury, spherical bone and can take in foramen magnum - diastasis of sutures

Question 17

What is usually the cause of fissure fractures?

Answer 17

blunt force - not much energy

Question 18

Difficulties of hairline fractures

Answer 18

impinge on other structures and a portal for spread of infection eg meningitis

Question 19

What can a depressed fracture give you a clue of?

Answer 19

the weapon - shape and size

Question 20

3 spaces where haemorrhages can occur

Answer 20

extradural
subdural
subarachnoid

Question 21

What is an extradural haemorrhage and give an example

Answer 21

Fractured temporal bone and bleeding middle meningeal artery - unconscious and dies eg footballer on the pitch

Question 22

haematoma

Answer 22

space occupying bruise

Question 23

Is a subdural haemorrhage associated with a fracture?

Answer 23

no

Question 24

What bleeds in subdural haemorrhage and why?

Answer 24

emissary veins
brain moves in relation to skull and dura
accelerating-decelerating haemorrhage

Question 25

What can chronic subdural haemorrhages lead to and how are they treated?

Answer 25

confusion and pressure

evacuate/drain

Question 26

Main 2 causes of subarachnoid haemorrhage

Answer 26

burst aneurysm eg berry aneurysm

blow to the chin - rotational acceleration

Question 27

What is croup and contrecoup in cerebral contusion?

Answer 27

coup = site of injury 
contrecoup = opposite area

Question 28

2 causes of intracerebral haemorrhage

Answer 28

natural disease eg hypertension

traumatic

Question 29

What suffers in diffuse axonal injury?

Answer 29

all neurons - swelling