TBI and Vascular conditions Flashcards
What is the most common stroke
ischemic 87%
the dominant precursor of stroke
The incidence of _____ rises as the
systolic or diastolic pressure rises
hypertension
infarction
Thrombosis
refers to obstructed blood flow due to a localized occlusion within one or
more vessels
Decreased blood flow to brain tissue can be caused by low system perfusion pressure
Systemic hypofunction
material formed elsewhere within the vascular system lodges in a vessel and blocks
the blood flow. The material arises proximally, mostly from the heart (such as from heart valves),
from major arteries such as the aorta, and from system veins
embolism
in general, left cerebral hemisphere strokes lead to
right
hemiparesis often with the arm, hand, and face more involved than the leg, right
hemisensory loss, aphasia, possible visual effect
Right cerebral hemisphere strokes
causes
left hemiparesis, often with the arm, face, and hand more involved than the leg, left
hemisensory loss, poor drawing and copying, and neglect of the left visual field
These
cerebral hemispheric lesions are most often caused by
carotid artery occlusion or
embolism to the middle cerebral artery or its branches.
Subarachnoid hemorrhage is predominantly caused by bleeding from an aneurysm located
circle of Willis
Hemorrhagic Strokes
bleeding inside the skull can be divided into subarachnoid, intercerebral, epidural, and
subdural hemorrhages
The most common brainstem lesions combine
a lesion of one or more
ascending or descending tracts with a lesion of one or more cranial nerves.
A lesion to a
descending or ascending tract (corticospinal, medial lemniscus, spinothalamic) results in
deficits that are
contralateral and below the level of the lesion
Transient ischemic attacks are, by definition, just that – episodes lasting
no longer 24 hours
with resolution of the neurological signs (usually within 20 – 30 minutes)
The progression of deficit over time is called a _______and requires immediate
attention.
stroke-in-evolution
A lesion of the oculomotor or trochlear nerve
lesion of the midbrain
A lesion of the trigeminal nerve
lesion of the rostral pons.
A lesion of the abducens, facial, or vestibulocochlear nerve
lesion of the caudal
pons
A lesion of the glossopharyngeal, vagus, or hypoglossal
lesion of the medulla
The most common brainstem lesions combine a lesion of one or more
ascending or descending tracts with a lesion of one or more
cranial nerves
The only ipsilateral long tract sign seen
in a brainstem lesion is caused by a lesion of the descending
hypothalamic fibers and
results in an ipsilateral Horner’s syndrome
Most common cause of TBI in children, teenagers, older adults
C: Falls
T: MVA
OA: Falls
MOI that lead to TBI
hitting head, blunt force trauma, whiplash, falls
Epidural hematoma
-an accumulation of blood between the
skull and the dura mater
-severe head injury with a temporal
bone fracture and resulting laceration of the middle meningeal artery
Subdual hematoma
-This is an accumulation of blood under the dura
and results from tearing of bridging veins which connect the surface of the brain to the
dural sinuses. Subdural hematoma may have both acute and chronic presentations
-can be life threatening
Cerebral contusion
-a localized area of brain swelling
-can lead to death
-the effects of such contusions are based on location
and size
Quick temporal assessment of severity of TBI
Glasgow Coma Scale
Mild moderate and sever TBI
Mild 13-15: Mental status change or loss of consciousness less than 30 minutes
Moderate 9-12: Mental status change or loss of consciousness between 30 minutes and 6
Severe <9 : Mental status change or loss of consciousness greater than 6 hours
Classes of concussion (3 Grades)
Grade 1: No loss of consciousness, all symptoms resolve
within 15 minutes
Grade 2: No loss of consciousness, symptoms last longer
than 15 minutes
Grade 3: Loss of consciousness for any period of time
Signs of concussion
concussion is best thought of as a mild traumatic brain injury
transient interruption of ARAS
Post concussion syndrome
will continue to experience headache and dizziness
for up to a month after a concussion
irritability,
depression, insomnia, and subjective intellectual dysfunction, fatigue, anxiety, and
excessive noise sensitivity have also been reported
Epidural and subdural hemorrhages are almost always
_______
