Traumatic Brain Injury Flashcards
What are the 2 most common causes of TBIs
about 50% are from MVA
2nd most common are falls
especially in elderly
What type of brain matter is damaged with an acceleration/deceleration of the brain
damages gray matter
what is damaged with rotational force?
damages the white matter
what is damaged with shearing?
this is a diffuse axonal injury that damages teh corpus callosum, cerebellar and cerebarl peduncles and subcortical white matter as well as the long axons of fornix
most often the most disabling damage that can cause immediate LOC
what is a coup
direct injury
what is a counter coup
rebound effect that can be a more devestating injury
3 signs of basilar fracture
• Periorbitial ecchymosis (raccoon sign) • Anosmia- absences of smell • CSF rhinorrhea o Fluid exiting the nose especially with lying down o Occurs from tearing of the dura
type of fracture highly associated with epidural hematoma
linear skull fracture
What is the difference between a subdural hygroma and hydrocephalus?
- Subdural hygroma is a collection of trapped CSF in the subarachnoid space and acts like a subdural hematoma which is accumulation of blood under the dura
- Hydrocephalus is CSF building up in the ventricles
Explain the vicious cycle of acute head injuries.
• Increased pressure occurs from the initial bleeding and swelling limited blood flow increased capillary dilation increased edema lack of nutrients neuronal death further swelling
What is the difference between decorticate and decerebrate posturing?
- Decorticate posturing is cortical white matter damage and cortical structures (diencephalon) that involves LE extension and UE flexion
- Decerebrate posturing is usually mid and upper brainstem damage that involves extension of all 4 extremities and is more deteriorating
What are the 3 types of hematomas
epidural
subdural
intracerebral
symptoms of epidural
• Epidural
o Develops between skull and dura
o Seen in more young patients
o Associated with linear skull fractures 90% of the time
o Headache, vomiting, decreasing neuro status
o “talk and die”
Seem fine after brief LOC then sudden fast deterioration
o Half as common as subdural
symptoms of subdural
• Subdural o Between dura and arachnoid o 40 and older are susceptible o Alcoholics are vulnerable o Signs/symptoms are similar to epidural BUT seizures are much more common
symptoms of intracerebral
• Intracerebral o Blood mass within the brain tissue o > 5 ml o Most often in temporal or frontal lobe o Associated with severe trauma o Significant focal neuro deficits