Trauma Neurpath Flashcards
what artery usually affected in epidural hematoma?
middle meningeal
what can the accumulation of blood in epidural space lead to in a hematoma?
mass effect
what herniation can epidural hematoma cause?
transtentorial or uncal herniation
what is the talk and die syndrome associated with?
epidural hematoma…it is lucid interval before lapsing into a coma
where is subdural hematoma located?
in the space btw dura and arachnoid
what is common cause of subdural hematoma?
tearing of bridging vein from inertial forces
how does minimal head trauma sometimes cause subdural hematoma?
patients with predisposing factors like atrophy, alcoholism, anticoag therapy can lead to predilection for subdural hematoma
what are four predisposing factors for subdural hematoma?
brain atrophy
anticoag treatment
alcoholism
recurrent falling
are subdural or epidural more common hematomas?
subdural
what are the two main types of subdural hematoma?
acute and chronic
what is timeframe for acute subdural?
within 3 days
what is time frame for chronic subdural hematoma?
many weeks
how does a chronic subdural hematoma progress?
have acute hematoma that forms and clots off then macros come to clean up and leave weak vessels that then rebleed and build up with minor traumas
what does the acute subdural hematoma get covered by that can lead to chronic?
fibrovascular membranes
what usually causes subarachnoid hemorrhage?
trauma
what is a brain contusion?
cortical hemorrhage
what is cause of cortical hemorrhage/brain contusion?
surface of brain contacts the bony protuberances on the underside of the frontal and temporal lobes
what accompanies the brain hemorrhage in contusions?
necrosis
what are the common locations for contusions of the brain?
inferior frontal gyri, frontal and temporal poles and cortex above and below the sylvian fissure
what are the two types of contusions?
coup and countercoup
what is a coup contusion?
contusion is at site of impact
what is a countercoup contusion?
contusion is at site opposite of impact
coup contusions are common with what type of trauma?
blow to head
countercoup contusions are common with what type of trauma?
falls
inertial forces can cause what type of issue in the brain?
diffuse axonal injury and diffuse vascular injury…leading to diffuse brain injury
what is the type of strain that leads to diffuse brain injuries from interial forces?
mechanical strain on axons and vessels
what is a diffuse axonal injury?
diffuse shearing of axons following traumatic brain injury
what is result of diffuse axonal injury?
often leads to coma…following a TBI
how do axons appear on histo following diffuse axonal injury?
axonal swellings appear with retraction bulbs
what is CTE?
chronic traumatic encephalopathy
what lobes are preferred in CTE?
frontal and temporal
what happens in the brain tissue with CTE?
atrophy of cerebral hemis and cerebellum
shaken baby syndrome presents with what triad?
acute encpehalopathy, subdural hematomas, retinal hemorrhages
name the two complications associated with calvarial skull fracture
middle meningeal artery rupture…epidural hematoma
contusion of underlying brain tissue
name two complications of basilar skull fracture
CSF leak from nose or ear, meningitis risk
risk of tearing cranial nerves or pituitary stalk
name 4 findings in CTE
atrophy of mamillary bodies
ventriculomegaly
substantia nigra pallor
thin corpus callosum
what are common symptoms of CTE?
emotional lability, personality change, memory impaired, dementia, cerebellar impairment, aggression, poor judgement, suicide
