Traumatic Brain and Spine Injury

Question 1

What are the main types of skull fractures?

Answer 1

linear fractures

Depressed (open, closed, comminuted)

Question 2

Define concussion:

Answer 2

clinical term referring to brain injury caused by trauma to the head

Question 3

what is the main cause of death in uder 45s in western societies?

Answer 3

traumatic brain injury

Question 4

How is consciousness measured?

Answer 4

by the Glasgow Coma Scale (3-15)

Question 5

what are the possible classfication according to the GCS?

Answer 5

13 mild brain injury

Question 6

what is measured as part of the GCS?

Answer 6

eye opening 4
verbal response 5
motor response 6

Question 7

define contusion

Answer 7

haemorrhagic necrosis of the brain

Question 8

what are the common sites for contusions?

Answer 8

superior frontal lobe

inferolateral temporal bone

Question 9

main types of contusions?

Answer 9

Coupe and Counter-coupe

Question 10

Why is the damage with missile injuries so bad?

Answer 10

due to high kinetic energy tissue can rupture at sites of vunerability (ponto-medullary juction)

Question 11

two types of dura matter injury are

Answer 11

Epidural (damage to the middle meningeal artery)

Subdural (between dura and arachnoid due to damage to the subdural veins)

Question 12

brain lacerations are

Answer 12

penetrations of foreign bodies or skull fragments that disrupts the continuity of the parenchyma

Question 13

what are some of the long term sequelae of brain trauma

Answer 13

infection
hydrocephaly
epilepsy
chronic traumatic encephalopathy

Question 14

What are axonal spheroids

Answer 14

accumulation of axonal matter and intracellular compounds at site of neuronal damage (not in the acute setting)

Question 15

Diffuse axonal injury is

Answer 15

loss of axons in the parenchyma of the brain after head trauma (corpus callosum site of damage likely to be)

Question 16

What is hydrocephalus

Answer 16

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

Question 17

how much blood/CSF is in the brain at each moment

Answer 17

150 ml

Question 18

Chronic Traumatic Encephalopathy

Answer 18

intelectual impairment due to continues chronic trauma to the brain
related to abnormal deposition of TAU protein and Ab amylloid

Question 19

Main causes of cerebral oedema in re CSF

Answer 19

increased production
decreased reabsorption
blockage

Question 20

cushing’s triad

Answer 20

High BP
Disrupted breathing
Decreased HR

Question 21

What is normopressure hydrocephalus

Answer 21

high levels of CSF in the brain due to decreased reabsorption happens more likely in the elderly

Question 22

What are the main functions of the Cingulate Gyrus (limbic cortex)

Answer 22

sensory inputs and emotions
emotional response to pain
modulation of aggressive behaviour
Related to depression and schizophrenia

Question 23

what are duret haemorrhages?

Answer 23

rupture of the vessels that supply the brainstem (midbrain) due to transtentorial herniations of the brain as the vessels are fixed