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Neuro Pathology > Pathology of Head Injury > Flashcards

Pathology of Head Injury Flashcards

1
Q

Basic injury types

A 
Bruises 
Abrasions
Lacerations
Incisions
Thermal injuries
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2
Q

Definition of injury

A

The transfer of energy to tissue

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3
Q

What causes bruises?

A

Blunt force

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4
Q

Pathology of a bruise

A

Damaged little blood vessels
The blood ooses into the subcutaneous tissue and you get a bruise
They diffuse after

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5
Q

What is a black eye?

A

Peritorbital contusion

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6
Q

Pathology of a black eye

A

Blood will tract within the tissues (mainly under gravity) through looser tissues and plains that it can move. Looser tissues in the eyes allow for the blood to accumulate around the eye - leading to a black eye

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7
Q

What do symmetrical black eyes indicate?

A

Immediate suspicion of a deeper injury up into the base of the skull or further up

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8
Q

What is an abrasion or graze?

A

Injuries to superficial parts of the skin

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9
Q

Do abrasions/grazes tend to scab?

A

No

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10
Q

Types of lacerations

A

Tears

Splits

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11
Q

What causes lacerations?

A

Blunt force injuries

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12
Q

Types of incised wounds

A

Cuts

Incisions

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13
Q

What causes incised wounds?

A

Sharp force injuries

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14
Q

What would a smaller energy injury cause?

A

Bruising or abrasion

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15
Q

What would a bigger energy injury cause?

A

Laceration or incision

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16
Q

Pathology of incision

A

Energy is delivered over a very small area e.g. blade of a knife creating a true cut

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17
Q

Types of skull fractures

A

Ring fracture
Fissure fracture
Depressed fracture (“sign”)
Hairline fracture

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18
Q

Pathology of a ring fracture of the skull

A

Force travels in the bone from the area of the force
Very considerable energy is put into the skull
The fracture will spread out and cause a ing
Diastases - sutures can be caused to break

19
Q

What parts of the skull are especially susceptible to ring fractures?

A

Where weaker bones meet stronger bones

20
Q

What are fissure fractures usually a result of?

A

Blunt force

Less energy

21
Q

Do hairline fractures usually require treatment?

A

No

22
Q

Are hairline fractures obvious?

A

No - barely visible

23
Q

Pathology of a depressed fracture

A

Localized force to the skull
Little piece of bone has been pushed inwards due to application of the force
Shape will match the cause of the force

24
Q

Function of pia mater

A

Retains configuration of the brain

25
Q

Function of dural sinuses

A

Venous drainage

26
Q

Types of intracranial haemorrhage

A 
Extradural (epidural)
Subdural 
Subarachnoid 
Cortical contusion 
Intracerebral haemorrhage
Diffuse (axonal) injury
27
Q

Cause of extradural haemorrhage

A

Bleeding arteries

28
Q

What do 90% of people with extradural haemorrhages have associated with them?

A

Skull fracture

29
Q

Where is the bleeding in a subdural haemorrhage?

A

Between dura and arachnoid

30
Q

Pathology of subdural haemorrhage

A

In an injury - the skull stops moving but the brain keeps moving
The little veins that transverse the dural space are stretched and they overcome the tensile strength and burst - leading to bleeding.
Accumulation of venous pressure blood in the subdural space

31
Q

Who is more susceptible to a subdural haemorrhage? Why?

A

Brain shrinkage
- alcoholics
- elderly
They have more space for stretching their veins

32
Q

Where does a subarachnoid haemorrhage occur?

A

Between arachnoid and pia

33
Q

Types of subarachnoid haemorrhage

A

Spontaneous

Traumatic

34
Q

Causes of a spontaneous SAH

A

Ruptured berry aneurysm

35
Q

Causes of traumatic SAH

A

Specific form caused by sudden movements of the head with an accelerational AND rotational component

36
Q

Which artery is often damaged in a traumatic SAH?

A

Vertebral artery

37
Q

Pathology of cortical contusion

A

Accelerational/decelerational head injuries

38
Q

Types of cortical contusion

A

Coup

Contrecoup

39
Q

What is a coup cortical contusion?

A

Where the head strikes and the direct blow occurs to the head - there will be a contusion there on the brain - this is where the coup injury is

40
Q

What is a contrecoup cortical contusion?

A

Further cortical contusion opposite to the original injury site
Injury at frontal or even temporal poles

41
Q

Causes of intracerebral haemorrhage

A 
Natural disease
- HTN 
- AV anomaly (e.g. vascular tumours)
- amyloid angiopathy (in elderly - vessels become very delicate)
Traumatic injury
42
Q

Pathology of diffuse (axonal) injury

A

When there is big accelerational/deceleration force that imply a certain rotation and makes the brain completely disrupted
All of the neurones suffer
Sometimes so much energy delivered to the brain that death can be intraosseous
Global disruption to the brain

43
Q

What causes a subdural injury?

A

Damage to the bridging veins between the cortex and the venous sinuses

44
Q

Damage to the MMA results in what?

A

Extra dural haematoma

Neuro Pathology (21 decks)

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