Response to traumatic brain injury

Question 1

Subarachnoid hemorrhage causes damage by:

Answer 1

• Raising ICP
• Direct pressure on tissue
• Depriving downstream tissue of blood
• Vasospams - ischemic injury
• Inflammation of meningies - increase CSF in ventricles - hydrocephalus

Question 2

Hydrochepahlus =

Answer 2

Dilated ventricles due to CSF

Question 3

Classic symptoms of subarachnoid

Answer 3

• Nucal stiffness
• Thunderclap headache
• Raised ICP symptoms

Question 4

Symptoms of subdural can be

Answer 4

Delayed in onset

Question 5

Symptoms of subdural:

Answer 5

Loss of consciousness
Vomiting
Focal lesion
Headache

Question 6

Subdural hematoma can lead to what in the brain

Answer 6

Midline shift

Herniation

Question 7

Concussion is a

Answer 7

diffuse brain injury

Question 8

Chronic concussions can cause a build up of

Answer 8

Tau proteins in neurones

Question 9

2 types of injury in concussion

Answer 9

Couo-coutercoup

Torque

Question 10

Troque injuries can effect

Answer 10

Reticular activating system

Question 11

What can cause rapid cerebral oedema after concussion

Answer 11

Secondary impact syndrome

Question 12

Symptoms of concussion

Answer 12

Memory loss
Confusion
LOC

Question 13

Hematoma =

Answer 13

A collection or clotting of blood outside the vessel.

Question 14

Types of altered conscious level in response to injury:

Answer 14

• Loss of consciousness
• Post-traumatic amnesia
• Pre-traumatic amnesia

Question 15

Why should you always ask about memory and LOC around time of trauma?

Answer 15

PTA is an important risk factor for a brain bleed

Question 16

Primary brain injury =

Answer 16

Occurs during initial insult, mechanical damage

Question 17

Primary brain injuries can be what?

Answer 17

Focal or diffuse

Question 18

What can cause progressive brain damage?

Answer 18

Mechanoporation
Calcium flux
O2 free radicals
Cytokine
Axotomy

Question 19

Axotomy =

Answer 19

severing an axon

Question 20

Secondary injury =

Answer 20

Not caused by mechanical damage. Results from the process initiated by trauma.

Question 21

Ex of things that can happen AFTER inital injury

Answer 21

Seizures

Infection

Question 22

Ex of secondary injuries

Answer 22

Raised ICP
Hypoxic brain injury
Ischemic brain injury
Seizures 
Infection

Question 23

ICP =

Answer 23

Brain matter + CSF + Blood

Question 24

Cerebral blood flow is under what?

Answer 24

Autoregulation

Question 25

Autoregulation acts to

Answer 25

Maintain cerebral blood flow at all times. Vasodilartion and vasoconstriction

Question 26

Monroe-Kelly doctrine =

Answer 26

Decribes relationship between ICP, blood, brain and CSF. Decribes uncompensated state that is reached when mass reaches a certain size

Question 27

Initially, what happens when ICP increases

Answer 27

CSF less produced, more absorbed

Vasoconstriction

Question 28

Normal ICP =

Answer 28

10 mmHG

Question 29

Abnormal ICP

Answer 29

> 20 mmHg

Question 30

Severe ICP

Answer 30

> 40 mmHg

Question 31

Mass effect =

Answer 31

phenomenon in which a focal lesion causes surrounding areas of brain tissue or brain structures to be compressed and injured due to the degree of space that leaking blood, cerebrospinal fluid, or edema takes up within the restricted skull space.

Question 32

CPP stands for

Answer 32

Cerebral perfusion pressure

Question 33

CPP =

Answer 33

MBP - ICP

Question 34

What compensated for increased ICP to maintain CPP

Answer 34

Cushing response

Question 35

Cushing reflex =

Answer 35

Increase BP to maintain CPP in response to ICP

Question 36

Head injury will do what to BP?

Answer 36

Increase

Question 37

To save the brain …

Answer 37

Save the heart