Raised ICP, SOL's & Trauma Flashcards
What part of the dura separates the cerebral hemisphere?
Falx Cerebri
What part of the dura lays just superior to the cerebellum?
Tentorium cerebelli
How should CSF appear normally?
Essentially clear
- May be a very small number of lymphocytes
What level should CSF glucose be?
> 2.2mol/L
What can cause a reduction in CSF reabsorption?
Post Sub-arachnoid haemorrhage
Meningitis
What is the difference between communicating & non-communicating hydrocephalus?
In non-communicating there is an obstruction to CSF flow within the ventricular system. whereas, is communicating the obstruction is outside of the ventricular system.
How do ventricles become enlarged in Hydrocephalus ex Vacuo?
Loss of brain parenchyma means ventricles enlarge and volume of CSF increases to compensate for loss of brain mass
What is an example of a disease process that can lead to Hydrocephalus ex Vacuo?
Alzheimer’s
How can subfalcine herniation manifest clinically?
Weakness of contralateral leg
How can tentorial herniation manifest clinically?
Pupillary dilation
Lack of pupil response to light
Ipsilateral impairment of ocular movement
How can tonsillar herniation manifest clinically?
Death
Compromises respiratory center
Where are childhood cancers most likely to present?
70% below tentorium cerebelli
Where are metastatic brain tumours most likely to be found?
Border between white & grey matter
What is the most common brain tumour in children?
Medulloblastoma
Where are medulloblastomas located?
Midline of the cerebellum
What is multiple abscesses indicative of?
Haematogenous spread
How is abscess diagnosed?
CT or MRI showing ‘ring enhancing lesion’
What is the most likely causative organism of bacterial meningitis in neonates?
E coli
What is the most likely causative organism of bacterial meningitis in infants & children?
H Influenzae
What is the most likely causative organism of bacterial meningitis in Adolescents & young adults?
N Meningitidis
What is the most likely causative organism of bacterial meningitis in older adults or children?
S pneumoniae
What is the difference between primary and secondary brain injury?
Primary - At the time of insult
Secondary - Injury that accumulates after incident
What are brain contusions?
Basically brain bruises
Where in the brain is most susceptible to diffuse axonal injury?
Central areas (i.e. brainstem, corpus callosum etc.)
Are haematomas more likely to be intradural or extra-dural?
80% intradural
The disruption of which artery is most likely to cause extradural haematoma?
Middle meningeal artery
What causes subdural haematoma?
Disruption of bridging veins
Are extradural or subdural haemorrhages more associated with trauma?
Subdural
