Traumatic Brain Injury Flashcards

1
Q

What group does TMI mainly affect

A

Young adults

Leading cause of death <45 years

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2
Q

What % of patients with head injury have long term disabiltiy

A

50

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3
Q

What is the thinnest part of the skull

A

Pterion

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4
Q

What runs under the pterion

A

Middle mesangial artery

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5
Q

What is a space occupying lesion

A

Something extra in cranial cavity like blood/ swelling

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6
Q

How may space occupying lesion be compensated for

A
  • CSF into the spine

- Venous blood into circulation

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7
Q

What is the intracranial pressure in a compensated state

A

ICP is normal

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8
Q

At what point does ICP begin to rise

A

Point of decompensation

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9
Q

What does cerebral perfusion pressure=

A

=Mean Arterial Pressure- Intracranial pressure

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10
Q

Why does it matter when ICP increases

A

Most other organs perfused with blood at mean arterial pressure
As ICP increases, effective perfusion pressure in the brain decreases

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11
Q

What happens with CPP falls

A

Cerebral blood flow falls

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12
Q

Apart from decreasing cerebral blood flow, what else does ICP cause

A

Herniation of the brain outside of the skull

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13
Q

What are Duret Haemorrhages

A

Small lineages of blood in midbrain and pons caused by traumatic downward displacement of brainstem

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14
Q

What are the 2 layers of the dura mater called

A
Outer= periosteal
Inner= meningeal
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15
Q

What is the munro-kelly doctrine hypothesis

A

Volume inside cranium is fixed
Cranium cannot be compressed
Box and its contents are in equilibrium

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16
Q

What molecular changes occur in the brain after injury (4)

A
  • Axons break and separate forming retraction balls
  • Neurons undergo apoptosis
  • Loss of energy and ion metabolism of injured cells
  • Cytotoxic oedema: injured cells swell up
17
Q

What is meant by neuroprotectipn

A

Therapy aimed at preventing neuronal cell death after injury with effect of improving outcome

18
Q

Define coma

A

Inability to open eyes, vocalise words and obey simple commands

19
Q

How does coma affect respiration and circulation (4)

A

Depresses cough, gag and swallow
Slows ventilation
Decreases BP
Adequate perfusion of oxygenated blood vital

20
Q

Where do epidural bleeds happen

A

Above the dura- between cranium and the dura mater

21
Q

When do epidural bleeds happen

A

Can happen as result of damage at pterion

Arterial bleeds

22
Q

Where do subdural bleeds happen

A

Between dura mater and arachnoid mater

23
Q

When do subdural bleeds happen

A

Damage to bridging veins that cross subdural space

24
Q

Where do subarachnoid bleeds happen

A

Between arachnoid and pia mater

25
Q

What 4 components do management centres for head injury centre around

A

Prevention
Resuscitation
Rapid neurosurgical intervention if appropriate
Rehabilitation