Traumatic Brain and Spine Injury Flashcards
What are the main types of skull fractures?
linear fractures
Depressed (open, closed, comminuted)
Define concussion:
clinical term referring to brain injury caused by trauma to the head
what is the main cause of death in uder 45s in western societies?
traumatic brain injury
How is consciousness measured?
by the Glasgow Coma Scale (3-15)
what are the possible classfication according to the GCS?
13 mild brain injury
what is measured as part of the GCS?
eye opening 4
verbal response 5
motor response 6
define contusion
haemorrhagic necrosis of the brain
what are the common sites for contusions?
superior frontal lobe
inferolateral temporal bone
main types of contusions?
Coupe and Counter-coupe
Why is the damage with missile injuries so bad?
due to high kinetic energy tissue can rupture at sites of vunerability (ponto-medullary juction)
two types of dura matter injury are
Epidural (damage to the middle meningeal artery)
Subdural (between dura and arachnoid due to damage to the subdural veins)
brain lacerations are
penetrations of foreign bodies or skull fragments that disrupts the continuity of the parenchyma
what are some of the long term sequelae of brain trauma
infection
hydrocephaly
epilepsy
chronic traumatic encephalopathy
What are axonal spheroids
accumulation of axonal matter and intracellular compounds at site of neuronal damage (not in the acute setting)
Diffuse axonal injury is
loss of axons in the parenchyma of the brain after head trauma (corpus callosum site of damage likely to be)
What is hydrocephalus
dilation of the vetricles of the brain due to blockage of the exit of CSF at 4th ventricle that causes compression of the brain parenchyma and related structures
how much blood/CSF is in the brain at each moment
150 ml
Chronic Traumatic Encephalopathy
intelectual impairment due to continues chronic trauma to the brain
related to abnormal deposition of TAU protein and Ab amylloid
Main causes of cerebral oedema in re CSF
increased production
decreased reabsorption
blockage
cushing’s triad
High BP
Disrupted breathing
Decreased HR
What is normopressure hydrocephalus
high levels of CSF in the brain due to decreased reabsorption happens more likely in the elderly
What are the main functions of the Cingulate Gyrus (limbic cortex)
sensory inputs and emotions
emotional response to pain
modulation of aggressive behaviour
Related to depression and schizophrenia
what are duret haemorrhages?
rupture of the vessels that supply the brainstem (midbrain) due to transtentorial herniations of the brain as the vessels are fixed
