Pathophysiology

Question 1

Skull fractures can lead to:

Answer 1

• Brain contusions: bruise of brain tissue
• Brain lacerations-
• Traumatic aneurysms:
• Cranial nerve damage:

Question 2

Brain Contusions:

Answer 2

Bruise of brain tissue

Question 3

Brain lacerations:

Answer 3

associated with a TBI, brain tissue is mechanically cut or torn

Question 4

Traumatic aneurysms:

Answer 4

intracranial aneurysm as a result from a non-penetrating head injury

Question 5

Cranial nerve damage:

Answer 5

a result of specific nerves that are damaged

Question 6

Depressed fractures:

Answer 6

Usually comminuted with broken portions of bone displaced inward may require surgery.

• decrease volume of the cranial cavity
• Can produce lower brainstem herniation and vegetative state ( characterized by open eyes and the appearance of wakefulness, PVS- coma, no awareness or wakefulness

Question 7

PVS:

Answer 7

perceptive vegetated state

-coma: no awareness or wakefulness

Question 8

Tearing of vascular structures producing hematomas:

Answer 8

Epidural hematoma
subdural hematoma
intracerebral hematomas
-All types of hematomas occupy space and compress brain tissue: This can can lead to additional brain damage, and herniation which can result in vegetative disturbances (apnea, decrease HR and increase BP

Question 9

Epidural hematoma:

Answer 9

blood accumulates on top of the dura matter

Question 10

Subdural hematoma

Answer 10

Blood accumulates beneath the dura

Question 11

Intracerebral hematomas:

Answer 11

Characterized by the formation of the formation of a blood mass within the brain tissue at the site of contusion

Question 12

Primary brain damage

Answer 12

-Brain is floating in cerebrospinal fluid
-Compression at site of impact tears and bruises nerve fibers (contusion), producing local brain injury
-Areas of the brain most susceptible to injury include the frontal and temporal lobes
~Bony ridges in the skull enhance the likelihood of lacerations and contusions at these sites
~Cognitive, memory and receptive language deficits are common.

Question 13

Diffuse brain damage or diffuse axonal injury is produced by:

Answer 13

• Compression: waves traveling through the brain

- Twisting & shear forces leading to stretching, snapping, shearing of axons

Question 14

Coup:

Answer 14

Contrecoup injury:

-With severe blow, rebound causes additional injury resulting in polar brain damage.

Question 15

Secondary brain damage:

Answer 15

Insults that evolve over time and are the direct result of events set in motion by the initial injury.

Question 16

Examples of secondary brain damage:

Answer 16

• Raised intracranial pressure may lead to brain herniation
• arterial hypoxia and brain ischemia
• cerebral edema-usually peaks 3-5 days
• arterial hypotension (blood loss)
• impaired salt and h2o balance
• intracranial infection
• hydrocephalus