Trauma Flashcards
What is spinal shock?
loss of sympathetic tone leading to hypotension following spinal cord injury
A young child comes in after a fall and is alert and moving all extremities. Should the spine be imaged?
yes - in young children, clinical criteria can miss injuries
What is the best tx for subdural hematoma?
rapid neurosurg consult
When should head CT be performed for concussion?
LOC, persistent headache, emesis, age (older thn 60), drug intoxication, persistent anterograde amnesia, evidence of bony injury, seizure
Describe the grading of concussions and how it determines treatment.
Grade 1 - no LOC, all sx resolve in 15
Grade 2 - no LOC, sx last longer than 15
Grade 3 - LOC
Grade 1 and 2 can be discharged after 1 -2 hours observation
How long does post concussive amnesia usually last?
as long as the LOC
How long does PCS (post concussive syndrome) usually last?
self limited, usually to weeks/months
What is the most common cause of non traumatic aneurysms?
Ruptured berry aneurysms
What are the risk factors for aneurysm?
Fibromyscykar dysphasia, poly cystic kidney disease, severe HTN, collagen vascular disease, OCPsp
A patient who had a SAH presents with headache, vomiting, blurry vision, double vision, somnolence. Suspect…
Acute
Communicating hydrocephalus from obstruction of subarachnoid granulations.
When is CT most effective in picking up SaH?
24 hours after
What is the treatment for a suspected ruptured aneurysm?
Get angiography and neurosurg involved
Can coil or clip - clip within 48
Hours or wait 2 weeks to reduce vasospasm
What steps can be taken to reduce the risk of vasospasm?
Triple H therapy - hypertension, hyoervolemia, hemodilution
A patient presents with thunderclap headache, nausea, blurry vision and anisocoria. Where is the aneurysm?
Likely PCOM compressing third nerve
What is the best diagnostic study for a predicted SAH?
Head CT without contrast
