Trauma Cases - Baisden Flashcards
Provide some criteria for the definition of Brain death.
Absence of reflexes and response to pain or other stimuli.
Absent respiratory drive in the absence of drugs & metabolic imbalances.
Warmth and stable blood pressure (warm & dead)
Why are epidural hemorrhages “lens-shaped” Why do they not spread further?
This is the space they push out from the skull into the brain parenchyma. They do not push out further because they are limited by the bony suture lines.
How can increased ICP be relieved?
Ports, drains, shunts, or craniotomy (eg cranialization of frontal sinus).
Name some possible causes for hydrocephalus in a newborn.
How should infant ventricular patency compare to that of an adult?
Generally decreased CSF outflow due to congenital malformations (eg Ventricular atresia)
The ventricles should be smaller–ventricles enlarge with age.
What is pictured?
Hydrocephalus.
What is pictured?
Subdural hematoma (note the gradient of fluid brightness indicating chronic bleeding and rebleeding)
What regions of this brain have been injured?
What could cause this?
Is this a typical location?
The inferior frontal and temporal lobes.
Contusions, either coup or contrecoup.
Yes; these overly the irregular orbital surfaces and middle-cranial fossae.
What function is served by a Burr hole?
Allows for drainage of a subdural or epidural hemorrhage.
This is basically trepannation!
What type of skull fracture is featured in red?
Comminuted.
Why does advanced age increase your suspicion for a subdural hematoma?
In subdural hematomas, vessels are town which normally bridge up to the dura from below. With age, the brain parenchyma atrophies, pulling down on the vessels. This predisposes them to tearing with trauma.
