Traumatic brain and head injury Flashcards
What are the risk factors for traumatic brain injury?
young men and elderly, previous head injuries, residents of inner cities, alcohol and drug abuse and low socioeconomic status.
What is secondary brain injury?
Occurs when cerebral oedema, ischaemia, infection, tonsillar or tentorial herniation exacerbates the original injury
The normal cerebral auto regulatory processes are disrupted following trauma rendering the brain more susceptible to blood flow changes and hypoxia
What is an Extradural (epidural) haematoma?
Bleeding into the space between the dura mater and the skull. Often results from acceleration-deceleration trauma or a blow to the side of the head.
What artery is affected in Extradural (epidural) haematoma?
middle meningeal artery
What brain lobe is affected in Extradural (epidural) haematoma?
Temporal lobe
What are the features in Extradural (epidural) haematoma?
LOC, nausea, vomiting, headache, papilledema (maybe a Cushing’s triad)
What shape is shown on the CT scan of Extradural (epidural) haematomas?
Biconvex shape on CT scan
What is a typical presentation of someone with Extradural haematoma?
A typical presentation is of a young patient involved in a head strike (either during sport or a result of a motor vehicle accident) who may or may not lose consciousness transiently.
Following the injury, they regain a normal level of consciousness (lucid interval), but usually, have an ongoing and often severe headache. Over the next few hours, they gradually lose consciousness.
Subdural haematoma
bleeding between dura and arachnoid
What lobes are affected in Subdural haematoma
commonly occur around the frontal and parietal lobes.
Subarachnoid haemorrhage
Bleeding between arachnoid and pia mater
Risk factors for Subdural haematoma
old age, alcoholism and anticoagulation, assaults, traumatic head injuries
What vessel is affected in Subdural haematoma?
bleed is cortical bridging tear (bridging vein)
What features are seen on CT scan of Subdural haematoma?
Moon crescent shape on CT scan – looks like extradural but much small convex shape
What region of the brain does Subarachnoid haemorrhage affect?
Source of bleed is around the circle of Willis – star shaped opacity in the middle of the brain where circle of Willis would be seen on CT/MRI scan.
