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1 STEP UWorld neuro+psycho > Pathoma head trauma 01-21 > Flashcards

Pathoma head trauma 01-21 Flashcards

1
Q

between dura and the skull?

A

Epidural hematoma.

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2
Q

Epidural hematoma. where collection?

A

between dura and the skull

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3
Q

Epidural hematoma. Classically why (fracture and vessel)?

A

due to fracture of the temporal bone with rupture of the MIDDLE MENINGEAL ARTERY; bleeding separates the dura from the skull.

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4
Q

due to fracture of the temporal bone with rupture of the MIDDLE MENINGEAL ARTERY?

A

Epidural hematoma.

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5
Q

Epidural hematoma. on CT?

A

lens-shaped lesion

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6
Q

Epidural hematoma. Lucid interva;l may preced neurologic signs.

A

.

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7
Q

Epidural hematoma. What lethal complication?

A

Herniation

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8
Q

Subdural hematoma. where collection of blood?

A

Collection of blood underneath the dura; blood covers the surface of the brain.

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9
Q

Collection of blood underneath the dura; blood covers the surface of the brain.

A

Subdural hematoma.

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10
Q

Subdural hematoma. what vessel?

A

tearing of bridging veins that lie between the dura and arachnoid; usually arises with trauma

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11
Q

Subdural hematoma. on CT?

A

crescent-shaped

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12
Q

Subdural hematoma. Presentation?

A

progressive neurologic signs

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13
Q

Subdural hematoma. in what population increased risk?

A

Increased rate of occurence in the elderly due to age-related cerebral atrophy, which stretched the vein.

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14
Q

Increased rate of occurence in the elderly due to age-related cerebral atrophy, which stretched the vein?

A

Subdural hematoma.

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15
Q

Subdural hematoma. What complication?

A

Herniation is lethal complication

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16
Q

Herniation. Definition?

A

Displacement of brain tissue due to mass effect OR increased intracranial pressure.

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17
Q

Displacement of brain tissue due to mass effect OR increased intracranial pressure?

A

Herniation.

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18
Q

Herniation. 3 types?

A

Tonsilar;
Subfalcine;
Uncal

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19
Q

Herniation. Tonsilar what displacement?

A

Displacement of the cerebellar tonsils into the foramen magnum.

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20
Q

Displacement of the cerebellar tonsils into the foramen magnum?

A

Herniation.

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21
Q

Herniation. Tonsilar. What complication?

A

Compression of the brain stem leads to cardiopulmonary arrest.

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22
Q

Compression of the brain stem leads to cardiopulmonary arrest?

A

Tonsilar herniation

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23
Q

Herniation. Subfalcine. What displacement?

A

Displacement of the cingulate gyrus under the falx cerebri.

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24
Q

Displacement of the cingulate gyrus under the falx cerebri?

A

Subfalcine herniation.

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25
Q

Herniation. Subfalcine. What complication?

A

Compression of the anterior cerebral artery leads to infarction.

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26
Q

Compression of the anterior cerebral artery leads to infarction?

A

Subfalcine herniation.

27
Q

Herniation. Uncal. what displacement?

A

Displacement of the temporal lobe uncus under the tentorium cerebelli.

28
Q

Displacement of the temporal lobe uncus under the tentorium cerebelli?

A

Uncal herniation.

29
Q

Uncal herniation. Compression related to eyes?

A

Compression of cranial nerve III (oculomotor) leads to eye moving ,,down and out” and dilated pupil.

30
Q

Compression of cranial nerve III (oculomotor) leads to eye moving ,,down and out” and dilated pupil?

A

Uncal herniation.

31
Q

Uncal herniation. Compression that leads to occipital lobe infarction?

A

Compression of posterior cerebral artery leads to infarction of occipital lobe (contralateral homonymous hemianopsia)

32
Q

Compression of posterior cerebral artery leads to infarction of occipital lobe (contralateral homonymous hemianopsia)?

A

Uncal herniation.

33
Q

Uncal herniation. What rupture -> complication?

A

Rupture of the paramedian artery leads to Duret (brainstem) hemorrhage)

34
Q

Rupture of the paramedian artery leads to Duret (brainstem) hemorrhage)?

A

Uncal herniation.

35
Q

UW. Epidural hematoma - vessel?

A

middle meningeal artery

36
Q

UW. Subdural hematoma - vessel?

A

bridging cortical veins

37
Q

UW. Epidural hematoma - location?

A

between skull and dura mater

38
Q

UW. Subdural hematoma - location?

A

Between dura mater and arachnoid mater

39
Q

UW. Epidural - manifestation?

A

transient lost of consciousness -> lucid interval (patients regain consciousness)-> eventual expansion of hematoma -> incr. ICP -> loss of consciousness aka neurologic deterioration

40
Q

UW. Subdural - manifestation?

A

Acute: coma at onset
Chronic: gradual onset of headache and confusion

41
Q

UW. Epidural. CT?

A

lentiform - BICONVEX
hyperdense (white)

42
Q

UW. Subdural. CT?

A

Crescent-shaped hematoma

43
Q

Epidural. What region in skull is the thinnest region -> vulnerable francture?

A

Pterion - region where parietal, frontal, temporal and sphenoid bones meet in the skull.

44
Q

fracture of pterion -> what vessel damage?

A

middle meningeal artery -> epidural

45
Q

Why epidural need prompt treatment?

A

because artery is damaged -> high pressure

46
Q

UW. Epidural complications?

A

Elevated intracranial pressure + brain herniation with death

47
Q

Signs of incr. ICP?

A

Altered mental status, nausea/vomiting, Cushing reflex

48
Q

What is Cushing reflex?

A

bradycardia, irregular breathing, hypertension

49
Q

Middle meningeal artery is branch of what?

A

maxillary artery (one of the terminal branches of the EXTERNAL carotid artery) - enters the skull at the foramen spinosum and supplies dura mater and periosteum.

50
Q

UW. Subdural. Bridging cortical veins - carries blood from what?

A

carry blood from the cortex to the venous sinuses.

51
Q

Bridging cortical veins rupture due to what injury?

A

Acceleration-deceleration injury

52
Q

Subdural. What onset of symptoms?

A

Gradual onset due to slow venous bleeding

53
Q

Subdural - what patients complain?

A

gradually worsening headache and display slow decline in mental function.

54
Q

Subdural in elderly - presentation?

A

gait abnormalities, seizures, somnolence, confusion and memory loss. Patients may go undiagnosed for weeks.

55
Q

Subdural hematoma and retinal hemorrhage in children - why?

A

Abusive head trauma aka ,,shaken baby syndrome” - due to blunt force trauma of vigorous shaking.

56
Q

Why infants are susceptible to shaking?

A

They have larger heads, enlarged subarachnoid spaces, higher brain water content, and decreased cervical muscle tone compared to older children.

57
Q

Abusive head trauma what vessel?

A

bridging veins -> subdural hematoma

58
Q

Abusive head trauma - may be acute and chronic due to repeated trauma over weeks to months.

A

.

59
Q

why retinal damage in abusive head trauma?

A

due to rupture of congested retinal veins.

60
Q

Abusive head trauma - what fractures?

A

posterior rib fractures - because perpetrator grasp the torso

61
Q

Vit. K deficiency in infants - what difference from abusive head trauma?

A

bleeding with intracranial, umbilical and GI bleeding, but RETINAL HEMORRHAGES ARE NOT SEEN

62
Q

What hematoma may span midline falx?

A

Epidural

63
Q

What hematoma cannot span midline falx?

A

Subdural

1 STEP UWorld neuro+psycho (10 decks)

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