TBI Intro & Pathophys: Diffuse Injury Flashcards

1
Q

what is a diffuse axonal injury

A

axon tears in half

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2
Q

what forces cause an axonal injury

A

acceleration, deceleration, rotational forces –> widespread shearing and retraction of damaged axons

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3
Q

most common cause of axonal injury

A

motorcycle / car accidents

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4
Q

what does an axonal injury result in

A

traumatic “micro bleeds”
significant neurological involvement
poor prognosis

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5
Q

what are the most affected areas with a axonal injury

A

corpus callosum
basal ganglia
brainstem
cerebellum

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6
Q

what secondary brain damage post TBI would someone get

A

electrolyte imbalance and mass release of damaging neurotransmitters

“metabolic cascade” apoptosis

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7
Q

what other physiological responses to an initial injury look like

A
  • hypoxic/ischemia injury (respiratory, cardiovascular)

- swelling/edma: mass effect, with increased ICP

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8
Q

you get higher rates of herniation and death when what happens..

A

intracranial swelling found during secondary brain damage compared to primary injuries

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9
Q

what is the most common ABI

A

anoxic/hypoxic brain injuries

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10
Q

what is anoxic/hypoxic brain injuries

A

lack of oxygenated blood flow to the brain tissue

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11
Q

what is anoxic/hypoxic brain injuries caused by

A

cardiac arrest
CO2 toxicity
near drowning
severe internal/external bleeding –> systemic hypotension

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12
Q

when you have an anoxi/hypoxic brain injuries what does it typically result in?

what is the prognosis?

A
  • results in global damage
  • lower expected functional outcomes
  • poor prognosis for cognitive function
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13
Q

what are some more vulnerable areas for an anoxic/hypoxic brain injuries

A

hippocampus
cerebellum
basal ganglia

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14
Q

primary blast injuries

A
  • direct effect of blast overpressure on organs

- usually diffuse brain damage

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15
Q

primary blast injuries usually increase what

A

CSF or venous pressure

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16
Q

secondary blast injuries are what

A

shrapnel injury

17
Q

what is a shrapnel injury

A

multiple injuries due to a high velocity explosives

18
Q

what is a tertiary blast injury

A

direct blow to the head

19
Q

what do blast injuries lead to

A
edema
contusion
DAI
hematoma
hemorrhage
20
Q

retrograde amnesia

A

loss of memory of events prior to injury

21
Q

post traumatic amnesia

A

unable to remember or learn new info

22
Q

acute management diagnostic imaging

A

MRI
CT
PET: how the brain fxns
EEG: for seizures

23
Q

what medication management do you use for brain injury

A
decreased BP and ICP
decreased intracranial bleeding
anti seizure
decrease temp
decrease infxn rate
24
Q

surgical management

A

craniotomy
craniectomy
VP shunt, EVD