Trauma Flashcards
A motorcyclist got into an accident and comes to the emergency department. He appears to be lucid. CT scan shows a lens shaped lesion. What does he have and what kind of of trauma does he have?
He has epidurql hematoma which is due to fracture of the temporal bone with rupture of the middle meningeal artery. Bleeding separates the dura from the skull. Herniation is a lethal complication.
A patient comes to the ED. He is an elderly gentleman who presents with progressive neurologic signs. CT scan shows a crescent shaped lesion. What does he have and what could have caused it?
He has a subdural hematoma due to the tearing of bridging veins that lie between the dura and arachnoid. Usually arises with trauma. Increased rate of occurrence in the elderly due to age related cerebral atrophy which stretches the veins.
What is uncal herniation and what three things can it lead to?
It involves displacement of the temporal lobe uncus under the tentorium cerebelli.
- compression of cranial nerve III leading to the eye moving down and out and a dilated pupil
- compression of posterior cerebral artery leading to infarction of the occipital lobe(contralateral homonymous hemianopsia)
- rupture of the paramedian artery leads to Duret (brainstem) hemorrhage
What is subfalcine herniation and what does it cause?
Involves displacement of the cingulate gyrus under the falx cerebri. Compression of the anterior cerebral artery leads to infarction.
What is tonsilar herniation and what can it cause?
Involves displacement of the cerebellar tonsils into the foramen magnum. Compression of the brain stem leads to cardiopulmonary arrest.
