TBI Flashcards
If there is unconsciousness, particularly following trauma, there is probably…
brain damage
Who has the highest risk for brain injury?
Adolescents and those over 75
Age range in which majority of TBIs occur
15-24 years
2 types of focal injury in TBI
Coup
Contre-coup
2 causes of diffuse injury in TBI
Increased intracranial pressure
Diffuse axonal injury (DAI)
Diffuse axonal injury (DAI) (general)
Shear forces caused by twisting of the brain inside the skull
DAI cause in layman’s terms
Caused by “nicking” of non-elastic cell membrane (epineurium)
What does DAI do mechanically to the nervous system?
Torsion on white matter causing stretching and tearing of axons
Results of DAI
Memory loss
Concentration loss
Sleep disturbance
Seizures
Sites of DAI
Subcortical white matter Corpus callosum Internal capsule Cerebellar peduncles Brainstem Basal ganglia
In reference to sites of DAI, the lower you move down the neuroaxis…
the more the mortality of the patient is impacted
Cause of epidural hematoma
Usually result of a serious head injury
The deadliest of all head injuries
Epidural hematoma
Describe epidural hematoma
Arterial bleeding fills the cranial cavity very quickly, compressing brain tissue (high pressure bleed)
Epidural hematoma often results in…
brain injury and may lead to death (medical emergency)
Describe subdural hematoma
Occurs following rupture of vessel–usually a vein–between brain and dura (low pressure bleed)
3 types of subdural hematoma
Acute
Subacute
Chronic
Acute subdural hematoma onset of S&S
Usually appear immediately
Subacute subdural hematoma onset of S&S
Takes days to weeks to appear
Chronic subdural hematoma onset of S&S
Can take weeks to appear
What types of subdural hematoma is the most dangerous?
Acute
Subarachnoid or intraparenchymal hemorrhage is a result of…
blood pooling inside the brain
Usually accompanies subarachnoid hemorrhage if caused by trauma
DAI
Non-traumatic causes of subarachnoid or intraparenchymal hemorrhage
AVM
Chronic HTN
Brain tumors
Blood thinners
Cause of herniation
Mass lesion due to extreme increases in ICP (>25 mmHg)
The result of herniation
Compression
Ischemia
Duret hemorrhages
Subfalcal herniation affects…
frontal lobe
Synonym for uncal herniation
Transtentorial herniation
Subfalcal herniation
Herniation of the cingulate gyrus under the falx cerebri toward the opposite hemisphere
Uncal herniation
Herniation of part of the medial temporal lobe through the tentorial notch pressing the midbrain against the tentorium
Posturing caused by uncal herniation
Decorticate posturing
Tonsilar herniation
One tonsil of the cerebellum herniates through the foramen magnum, compressing the medulla against the margin of the foramen
Posturing caused by tonsilar herniation
Decerebrate posturing
Mechanism of decorticate posturing
Lesion at the level of the midbrain separating the forebrain from the brainstem
Mechanism of decerebrate posturing
Lesion at the level of the lower brain stem separating the brain from the spinal cord
