Traumatic Brain Injury

Question 1

3 Restraining Components for Brain (& major point)

Answer 1

1. Parasagittal bridging veins
2. Cranial Nerves
3. Tentatorium, falx, etc
   Very poor

Question 2

4 Interplaying Pathomechs for Brain Injury We See

Answer 2

Hematoma
Contusion
DAI
Hypoxia/Ischemia

Question 3

DAI Pathophysiology

Answer 3

NoR get damaged, causing ionic imbalance and loss of balance/function

Question 4

Deafferentation

Answer 4

Big brain damage problem. 2nd order neurons lack input, so you get spasticity

Question 5

Astrocyte Problems

Answer 5

Swell and impede bvs. reducing blood flow

Question 6

3 Steps from Increased IC Pressure

Answer 6

1. CSF Comes out so NEVER DO LUMBAR
2. Brain deforms/herniates
3. Blood flow occluded

Question 7

Duret Hemorrhage

Answer 7

Flame shaped at midbrain, from transtentorial herniation lacerating shit like b.v.s and III (fully palsy, test w/ dilated pupil) and w/in 1 hour you’re fucked

Question 8

Neuronal State of Persistent Vegetative State

Answer 8

None

Question 9

“Golden Hour” of Trauma Care

Answer 9

Do ABCs then documentation of neuro exam. Check basic things first. Gets exponentially worse (with more infarction) after this hour

Question 10

Canadian CT Head Rule/New Orleans Criteria

Answer 10

Never assume alcohol/substance abuse responsible for post-TBI neuro deficits. ALWAYS do CT

Question 11

Craniotomy

Answer 11

Big operation required to reduce IC pressure, open dura and bone as flap to alleviate swelling pressure and stop hemorrhage

Question 12

Ventriculostomy Catheter

Answer 12

Left in to test pressure and drain CSF

Question 13

Personality Changed after Severe TBI

Answer 13

Often intelligence preserved, but way worse personality features

Question 14

Mild TBI Brain Activity

Answer 14

More areas involved - have to work harder

Question 15

Most Cost Effective Surgical Procedure of These

Answer 15

Craniotomy for Epidural Hematoma