test 2 - hematomas Flashcards
accumulation of blood in the potential space between the inner table of the skull and the stripped off dural membrane
epidural hematoma
occurs 2% of pt’s with head injuries
5-15% pt’s with fatal head injuries
EDH
EDH is a ____ bleed
arterial
period of time when pt is upright, talking, then topples over
lucid period
caused by a focused blow to the head
EDH
EDH is most commonly located at what skull site
temporal
EDH ___ outnumber ___ 4:1
males outnumber females 4:1
untreated death usually results in ____ hours of EDH
6-24
neurological deficits of EDH
visual field def
aphasia
weakness
numbness
____ response is indicative of elevated intracranial pressure
bradypnea
bradycardia
hypertension
cushing response
CSF physical finding
leakage resulting from skull fracture with disruption of the dura
otorrhea
rhinorrhea
what is a hemotympanum
bruise somewhere other than where hit
ipsilateral dilation of the pupil due to compression of the oculomotor nerve
anisocoria
what are the three parameters of the Glasgow Coma Scale
eye opening
verbal response
motor function
13-15 : mild
9-12 : moderate
3-8 : severe
less than 8 are in coma
glasgow - eye scale
glasgow verbal scale
glasgow motor scale
how to score Glasgow Coma Scale score
E__V__M___ = GS ___
do not just write GS___
decorticate posturing indicates damage to
mesencephalic region or the corticospinal tract
decorticate pos.
flexed
decerebrate pos.
extended
decerebrate posture indicates
brain stem damage
prime imaging for immediate un-enhanced scan
CT
MRI is too slow
rapid clotting blood collection below the inner layer of the dura but external to the brain and arachnoid membrane
subdural hematoma
subdural hematoma is a ____ bleed
venous bleed
slow (7-28 days)
acute subdural hematomas develop in what 3 ways
bleeding by a damaged cortical artery
bleeding from underlying parenchymal injury
tearing of bridging veins from the cortex to one of the draining venous sinuses
subacute subdural hematoma phase begins ____ after injury
3-7 days
clotting
chronic phase of subdural hematoma begins about ____ weeks after acute injury
2-3 weeks
dissolution of the clot
T/F SDH is more common in people older than 60
TRUE
GCS score less than ___ after blunt head trauma, in a patient with no intoxicating substance use, warrants immediate CT scan
15
hematomas presenting 21 days or more after injury
chronic SBH
hematomas that present 4-21 days after injury
subacute SDH
the highest incidence of CSDH cases are in adults aged
70-79 years
CSDH - ___% have an interval of 1-4 weeks before symptoms develop
25
CSDH - __% experience symptoms from 5 weeks to 3 months before their hospital admission
25
CSDH - ____ of pts have no asymptomatic period
1/3 (33%)
what sign is in about 50% of CSDH pts
hemiparesis: weakness of one entire side of the body
