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(2) MS: Neurological Conditions 🩺 > S3_L6: Traumatic Brain Injury > Flashcards

S3_L6: Traumatic Brain Injury Flashcards

The sole reference of this flashcard deck is Merritt's Neurology, 14th ed.

1
Q

Linear skull fractures occur most commonly in what region, where the skull is thinnest?

A

temporoparietal

Source: Merritt 14th ed

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2
Q

It is a skull fracture where one or more fragments of bone are displaced inward, compressing the underlying brain

A

Depressed skull fracture

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3
Q

It is a skull fracture where there are multiple, shattered bone fragments, which may or may not be displaced.

A

Comminuted skull fractures

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4
Q

It is a mild TBI without obvious structural abnormality identified on standard neuroimaging. Loss of consciousness is a result.

A

Cerebral concussion

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5
Q

It is considered the single most important cause of persistent disability after traumatic brain damage.

A

Diffuse axonal injury (DAI)

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6
Q

Axonal shearing injury tends to be most severe in specific brain regions that are anatomically predisposed to maximal stress from what type of force?

A

Rotational forces

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7
Q

Small hemorrhages that are sometimes associated with focal-shearing lesions

A

Traumatic microbleeds

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8
Q

It is a focal parenchymal hemorrhage that result from scraping and bruising of the brain as it moves across the inner surface of the skull.

A

Cerebral contusion

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9
Q

Where are the most common sites of traumatic contusion as brain tissue in these areas come in contact with irregular protuberances at the base of the skull?

A

Inferior frontal and temporal lobes

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10
Q

These are linear tears of the meninges or cerebral tissue, usually a result of cuts from the sharp edges of depressed skull fragments.

A

Lacerations

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11
Q

These are focal collections of blood clots that displace the brain, in contrast to contusions, which resemble bruised and bloodied brain tissue.

A

Hematomas

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12
Q

TRUE OR FALSE: Contusions are found in cortical areas while most parenchymal hematomas are located in the deep white matter.

A

True

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13
Q

Subdural hematomas usually arise from what source?

A

Venous source

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14
Q

In subdural hematomas, blood fills the potential space between which membranes of the brain?

A

Dural and arachnoid membranes

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15
Q

Where are most subdural hematomas located?

A

Over the lateral cerebral convexities

Note: Subdural blood may also collect along the medial surface of the hemisphere, between the tentorium and occipital lobe, between the temporal lobe and the base of the skull, or in the posterior fossa

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16
Q

The Glasgow Coma Scale is based what three individual components?

A
  1. Eye opening
  2. Patient’s best verbal responses
  3. Patient’s best motor responses
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17
Q

It is a widely used as a semiquantitative clinical measure of the severity of brain injury. It also provides a guide to the prognosis.

A

Glasgow Coma Scale

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18
Q

A patient is in the comatose state. What is their Glasgow Coma Scale score?

A

Less than or equal to 8

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19
Q

An epidural hematoma, or bleeding into the epidural space, is usually caused by a tear in the wall of what artery?

A

Middle meningeal artery

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20
Q

TRUE OR FALSE: Elderly or alcoholic patients with cerebral atrophy are particularly prone to subdural bleeding.

A

True

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21
Q

In a subdural hematoma, the CT scan usually reveals a high-density, ____ collection across the entire hemispheric convexity

A

Crescentic / Cresent-shaped

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22
Q

You suspect a patient of yours to have a basilar skull fracture. Standard skull x-rays have not catched anything. What test and setting can you use to better identify structures in the brain?

A

CT bone windows

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23
Q

Brain injuries occur at all ages, but the peak between what age range?

A

15-24 years old

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24
Q

Head injury is the leading cause of death among people younger than the age of?

A

24 years

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25
Q

Traumatic brain injury is more prevalent in which sex?

A

Men are affected 3 or 4 times as often as women

26
Q

A fracture wherein the scalp was lacerated over it is considered as?

A

Open or compound fracture

27
Q

Match the risk category with its corresponding characteristics

  1. Focal neurologic signs
  2. May complain of headache and dizziness
  3. Posttraumatic amnesia
  4. May have scalp abrasion, laceration, or hematoma
  5. Alcohol or drug intoxication

A. Mild
B. Moderate
C. Severe

A
  1. C
  2. A
  3. B
  4. A
  5. B
28
Q

Match the risk category with its corresponding characteristics

  1. Normal neurologic examination
  2. Glasgow Coma Scale score of 3-8
  3. Penetrating skull injury or palpable depressed skull fracture
  4. No drug or alcohol intoxication
  5. Concussion, vomiting, seizure

A. Mild
B. Moderate
C. Severe

A
  1. A
  2. C
  3. C
  4. A
  5. B
29
Q

Match the risk category with its corresponding characteristics

  1. Progressive decline in level of consciousness
  2. Glasgow Coma Scale score of 9-14
  3. No concussion
  4. Comatose
  5. Unreliable or no hx of injury

A. Mild
B. Moderate
C. Severe

A
  1. C
  2. B
  3. A
  4. C
  5. B
30
Q

Match the risk category with its corresponding characteristics

  1. Age <2 y/o, >65 y/o
  2. Signs of possible basilar or depressed skull fracture of serious facial injury
  3. “talked and deteriorated”
  4. Confused, lethargic, stuporous

A. Mild
B. Moderate
C. Severe

A
  1. B
  2. B
  3. C
  4. B
31
Q

Most epidural hematomas are located over the convexity of the hemisphere in which cranial fossa?

A

Middle cranial fossa

Note: Occasionally, hemorrhages may be confined to the anterior fossa, possibly as a result of tearing of anterior meningeal arteries.

32
Q

TRUE OR FALSE: Coagulopathy and oral anticoagulants are important risk factors for subdural hematoma and is associated with increased mortality.

A

True

33
Q

In the neurologic assessment, the skull should be palpated for fractures, hematomas, and lacerations. A step-off or palpable bony shelf may indicate?

A

A depressed skull fracture

34
Q

The patient is conversant and disoriented. What score is given to this patient according to the Glasgow Coma Scale?

A

4

35
Q

The patient opens the eyes to hearing a voice. What score is given to this patient according to the Glasgow Coma Scale?

A

3

36
Q

The patient’s best motor response is extensor posturing. What score is given to this patient according to the Glasgow Coma Scale?

A

2

37
Q

The patient’s best motor response is localizes to pain. What score is given to this patient according to the Glasgow Coma Scale?

A

5

38
Q

The patient’s best verbal response is incomprehensible sounds. What score is given to this patient according to the Glasgow Coma Scale?

A

2

39
Q

The patient’s eyes open spontaneously. What score is given to this patient according to the Glasgow Coma Scale?

A

4

40
Q

The patient’s best motor response is withdrawing to pain. What score is given to this patient according to the Glasgow Coma Scale?

A

4

41
Q

The patient’s best motor response is flexor posturing. What score is given to this patient according to the Glasgow Coma Scale?

A

3

42
Q

TRUE OR FALSE: Among older adults, the most prevalent TBI mechanism of injury is falls, and TBIs occur more commonly in women.

A

True

43
Q

TRUE OR FALSE: Skull fractures are important markers of a possibly serious injury but rarely cause problems by themselves

A

True

44
Q

Most common skull fracture

A

Linear skull fracture

45
Q

TRUE OR FALSE: In most cases, depressed fractures are open (or “compound”) and liable to become infected or leak cerebrospinal fluid (CSF).

A

True

46
Q

TRUE OR FALSE: Most patients with concussion have normal CT or magnetic resonance imaging (MRI) findings because concussion results from physiologic, rather than structural, injury to the brain.

A

True

47
Q

What is the term for a traumatic coma lasting more than 6 hours?

A

Diffuse axonal injury

48
Q

Determine whether the DAI is mild or moderate or severe

  1. Coma lasting more than 24 hours
  2. Coma of 6 to 24 hours duration

A. Mild DAI
B. Moderate or severe DAI

A
  1. B
  2. A
49
Q

Hypertension, hyperhidrosis, and hyperpyrexia are autonomic dysfunctions common in patients with acute severe DAI. These may reflect injury to which two structures?

A

Injury to the brainstem or hypothalamus

50
Q

Fill in the blanks of the Criteria for hospital admission after head injury.

  • Intracranial blood or fracture identified on (1)___
  • Confusion, agitation, or depressed level of (2)___
  • (3)___ neurologic signs or symptoms
  • Posttraumatic (4)___
  • Alcohol or drug intoxication
  • Significant (5)___ medical illness
  • Lack of a reliable home environment for observation
A
  1. Head CT
  2. Consciousness
  3. Focal
  4. Seizure
  5. Comorbid
51
Q

What is the possible treatment for large, parenchymal hematomas with mass effect?

A

Surgical evacuation

52
Q

Post-traumatic brain swelling may result from (1)___, an increase in cerebral blood volume (CBV) resulting from abnormal (2)___, or both.

A
  1. cerebral edema
  2. vasodilatation
53
Q

TRUE OR FALSE: Brain swelling may follow any type of head injury

A

True

54
Q

Due to lateral forces, a contusion may occur at the site of the blow to the head, known as?

A

Coup lesion

55
Q

Due to lateral forces, a contusion may occur at the opposite pole as the brain impacts on the inner table of the skull, known as?

A

Contrecoup lesion

56
Q

When rotational forces lead to tearing of small- or medium-sized vessels within the parenchyma, what may occur?

A

Intracerebral hematoma

57
Q

Acute subdural hematomas are symptomatic within (1)___ of injury, while chronic subdural hematomas become symptomatic after (2)___.

A
  1. 72 hours
  2. 21 days
58
Q

What are the most common focal neurologic signs after an acute subdural hematoma?

A

Hemiparesis and pupillary abnormalities

Note: The usual picture is ipsilateral pupillary dilation and contralateral hemiparesis

59
Q

Extradural hemorrhage in the posterior fossa may occur when what structure has been torn?

A

Torcular herophili

60
Q

TRUE OR FALSE: Epidural hematoma is primarily a problem of young adults.

A

True

Note: It is rarely seen in the elderly because the dura becomes increasingly adherent to the skull with advanced age.

(2) MS: Neurological Conditions 🩺 (12 decks)

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