TBI

Question 1

which head injuries have acute bleeding

Answer 1

Subarachnoid hemorrhage
Epidural hematoma

Question 2

which head injuries have chronic bleeding

Answer 2

Intracerebral hematoma
Subdural hematoma

Question 3

What is the key difference between open and closed head injury?

Answer 3

Infection rate

Question 4

Which event is most likely to cause an open head injury?

Answer 4

Penetrating trauma

Question 5

Which post-traumatic brain syndrome is most like Alzheimer disease?

Answer 5

Chronic traumatic encephalopathy

Question 6

diagnosis of pt with left temporal skull fracture and cushing triad

Answer 6

epidural hematoma and intracranial HTN

Question 7

location in the brain in charge of breathing

Answer 7

pons

Question 8

epidural hematoma pathogenesis and complication (5)

Answer 8

1- Blunt trauma
2- Meningeal artery laceration
3- Epidural hematoma
4- Intracranial hypertension
5- Uncal herniation

Question 9

what does severe diffuse brain injuries result in (2)

Answer 9

axonal damage
Likely to cause disability

Question 10

primary brain injury (ex)

Answer 10

injury to the brain at the time of impact
ischemia

Question 11

secondary brain injury

Answer 11

an indirect consequence of primary injury (timing)

Question 12

examples of secondary brain injury (5)

Answer 12

ischemic neuron injury
neuron excitotoxicity
neuroinflammation
cerebral edema
intracranial hypertension

Question 13

severity of brain injury based on Glasgow coma scale

Answer 13

severe= 3-8 pts
moderate= 9-12pts
mild=13-15pts

Question 14

what does each category of Glasgow coma scale cover

Answer 14

eye opening=brainstem
verbal=cerebral
motor=signaling

Question 15

brain contusion

Answer 15

brain bruise

Question 16

coup vs contrecoup

Answer 16

coup= hit first
contrecoup= hit second,
rebound in opposite direction of coup

Question 17

subarachnoid space

Answer 17

located between the arachnoid mater and pia mater
filled with cerebrospinal fluid

Question 18

extradural space (ex)

Answer 18

between the skull and dura mater
-epidural hematoma

Question 19

subdural space (ex)

Answer 19

between the dura mater and arachnoid mater-subdural hematoma

Question 20

what are the 3 layers of the meninges (out to in)

Answer 20

dura, arachnoid, and pia

Question 21

signs of temporal epidural hematoma (5)

Answer 21

loss of consciousness,
↑ headache
Ipsilateral pupil dilation
Contralateral hemiparesis
vomiting

Question 22

Epidural Hematoma phases

Answer 22

trauma - confusion -lucid interval-
rapid deterioration-

Question 23

mild TBI characteristics

Answer 23

concussion
no loss of consciousness
signs- temporary (confusion)
anterograde amnesia <24h

Question 24

moderate TBI characteristics

Answer 24

severe concussion
loss of consciousness (30min)
signs- may be permanent
anterograde amnesia >24h

Question 25

severe TBI characteristics

Answer 25

coma
loss of consciousness (24h+)
signs- permanent
brainstem damage

Question 26

Diffuse axonal injury (DAI)

Answer 26

the brain rapidly moves inside the skull due to a blunt force and damages axons (stretches)

Question 27

brain contusion pathogenesis

Answer 27

related to coup and contrecoup

Blunt trauma- compression
-lacerate blood vessels- Blood leaks =brain contusion (grey matter)

Question 28

types of DAI

Answer 28

mild- microscopic, no signs
moderate- extensive, LOC
severe- widespread, coma

Question 29

bleeding in subdural hematoma

Answer 29

slow bleed
self- limiting (veins compressed)

Question 30

subdural hematoma (cause, complication, image)

Answer 30

tear of bridging veins
intracranial HTN
brain compression, herniation
crescent shaped

Question 31

signs of subdural hematoma

Answer 31

no loss of consiousness
confusion
slow to develop, gets worse

Question 32

similarity between chronic traumatic encephalopathy and Alzheimer

Answer 32

both -brain atrophy and Tau tangles, progressive dementing disease
CTE- repeated brain injury (sports)

Question 33

Why are survival outcomes improving for TBI (3)

Answer 33

safety measures (helmet, etc)
↓ response time
better medical management

Question 34

cause of TBI and who most at risk

Answer 34

external force (sports, MVA)
children and youth (males)