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Neuroanatomy Rewind Unit III > Traumatic CNS Injury and Repair > Flashcards

Traumatic CNS Injury and Repair Flashcards

1
Q

The 3 types of focal intracranial lesions are:

A

contusion, hematoma/hemorrhage, herniation syndromes

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2
Q

The 2 types of diffuse intracranial lesions are:

A

diffuse axonal injury (DAI), concussion

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3
Q

The 3 types of post-traumatic sequelae are:

A

pneumocephalus, post-concussion syndrome (PCS), chronic traumatic encephalopathy (CTE)

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4
Q

The 3 cellular events in general associated with axotomy are:

A

proximal stump, distal stump, transneuronal events

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5
Q

cervial spinal cord injuries are referred to as _________

A

tetraplegia

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6
Q

spinal cord injuries below T1 are __________

A

paraplegias

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7
Q

A grade A spinal cord injury is ________ with ___________

A

complete, no motor or sensory function below the lesion

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8
Q

A grade C spinal cord injury is __________ with ___________

A

incomplete, some motor strength

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9
Q

_____ is the leading cause of death for individuals younger than 45 years old, more than 50% are due to ________

A

trauma, TBI

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10
Q

All types of TBI involve __________

A

loss of consciousness

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11
Q

TBI injuries are always _________ and are considered _______ injuries

A

multifactorial, complex

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12
Q

A Glassgow coma scale is a way to classify _______

A

TBI

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13
Q

A glassgow coma number ______ is a severe TBI

A

<7

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14
Q

A glassgow coma number >12 is considered a ___________

A

mild TBI (good prognosis)

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15
Q

The __________ is not designed to test focal neurological deficits

A

Glassgow coma scale (GCS)

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16
Q

A __________ involves the skull moving faster than the brain causing the brain to strike the brain

A

closed head TBI

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17
Q

A _________ involves coup-countercoup, contusions, hemorrhage, and axonal sheering

A

closed head TBI

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18
Q

A ___________ involves cavitation stretches, vasculature and axons, and compression of neurons and glia

A

penetrating TBI

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19
Q

A 1 degree blast TBI involves __________, __________, and _________

A

pressure passes through the brain, stretching axons, and compression of neurons and glia

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20
Q

______ is easy to miss on CT scan

A

basal skull fracture

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21
Q

occult signs of basal skull fracture are _________, ________, and __________

A

leakage of CSF (otorrhea, rhinorhea), signs of cranial nerve damage (esp. I, VII, VIII), characteristic accumulations of blood

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22
Q

The 2 types of characteristic accumulations of blood in basal skull fracture are:

A

postauricular ecchymosis (Battle’s sign), periorbital ecchymosis (raccoon eyes)

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23
Q

The following cranial nerves are the most vulnerable in basal skull fractures:

A

I, VII, and VIII

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24
Q

A patient fractures her frontal bone, she experiences _________ and ___________, which are signs due to damage to ____

A

anosmia, apparent loss of taste (actually loss of flavor associated with CN I), CN I

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25
Q

A patient has either a transverse or longitudinal fracture of the petrous bone which affects ______ and ______.
He experiences ___________, __________, __________, and _________

A

CN VII, VIII, ipsilateral facial palsy typically permanent (unless surgical anastamosis of transected ends), ipsilateral deafness, postural vertigo, nystagmus

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26
Q

A ___________ is almost always accompanied by cortical contusions and surrounding edema

A

focal intracranial lesion

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27
Q

A ________ is an injury that results in hemorrhagic necrosis of brain tissue

A

contusion

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28
Q

A _______ injury produces mainly coup lesions

A

frontal

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29
Q

A ________ injury produces mainly countercoup lesions

A

occipital injury

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30
Q

Blows to the side of the head produce ______, ________, or both types of lesions

A

coup, countercoup

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31
Q

Most commonly injured areas in a contusion are _______ and ___________

A

orbitofrontal lobe, temporal lobe

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32
Q

contusion of _________ and __________ are rare due to smooth inner table of skull posteriorly

A

occipital lobes, cerebellum

33
Q

Contusions typically involve _____________ often superficially. They often only involve __________ due to this.

A

crests of gyri, gray matter

34
Q

lesions of a contusion often appear as ___________ mixed with areas of ______________

A

edematous regions of cortex and subcortical white matter, areas of increased density representing leaked blood

35
Q

Areas of leaked blood and fluid may _____________ in a contusion

A

coalesce and appear as a single large clot

36
Q

___________ are common sequelae that may develop with a contusion

A

delayed hematomas and edema

37
Q

The _____________ effect is a big factor in genesis of tissue shifts and elevated ICP in a contusion

A

mass effect

38
Q

craniotomy can relieve _______ after a contusion, but has no effect on _________

A

ICP, focal neurological deficit

39
Q

A contusion may appear as multiple _____________ adjacent to ____________

A

contusions, bony prominences

40
Q

________ is the most common post-traumatic bleed and may be unilateral or bilateral

A

acute subdural hematoma (SDH)

41
Q

___________ usually results from tearing of bridging veins

A

acute subdural hematoma (SDH)

42
Q

Patients may be __________ or ________ on admission with an SDH, or they may be ________

A

stuporous, comatose, alert

43
Q

Coma is typically developed ________ in patients with SDH, if it is present

A

immediately

44
Q

_______ is rarely observed in SDH

A

aphasia

45
Q

__________ is rarely observed in SDH because the ____________ is deep and not easily compressed

A

homonymous hemianopia, geniculocalcarine tract (optic radiation)

46
Q

In _________, the clot is initially hyperdense but becomes slowly more isodense on CT and may be difficult to detect

A

subacute SHD

47
Q

A subacute SDH is typically difficult to detect on CT except by the __________

A

tissue shift that it causes

48
Q

__________ is a reliable indicator of the side of the subacute SDH

A

dilation of ipsilateral pupil

49
Q

___________ may result in subacute SDH due to compression of the ____________

A

ipsilateral hemiparesis, compression of contralteral peduncle against edge of tentorium (Kernohan phenomenon)

50
Q

If _________ is bilateral, there will be no shift in tissue and effect can cause herniation which compresses upper brainstem

A

chronic SDH

51
Q

symptoms of chronic SDH are mainly associated with _______

A

increased ICP

52
Q

Symptoms of a __________ include headache, light-headedness, slowness in thinking, apathy, unsteady gait, and occasional seizures

A

chronic SDH

53
Q

epidural hematomas (EDH) typically arise with a _________ or _________ fracture and _____________. Or less commonly with _________

A

temporal, parietal, laceration of middle meningeal artery, tear in dural venous sinus

54
Q

A patient with a ___________ has an intial loss of consciousness that is brief followed by a lucid interval

A

epidural hematoma

55
Q

Signs and symptoms of a __________ may appear in a few hours and include worsening headache, vomiting, drowsiness, confusion, aphasia, seizures, and hemiparesis with mild babinski sign

A

epidural hematoma

56
Q

progression of a _________ can lead to a coma and ipsilateral pupil may dilate and be nonresponsive, decerebrate posturing may appear

A

epidural hematoma

57
Q

decerebrate posturing is associated with _________, due to herniation

A

worsening epidural hematoma

58
Q

__________ are hemorrhages associated with coup-contrecoup injuries which cause sheering forces that produce bleeding within white matter as well as gray matter in contused areas

A

intracerebral hemorrhage

59
Q

With intracerebral hemorrhage (or intraparenchymal hemorrhage) bleeding occurs in the _________ of one lobe of the brain or deeper structures like the _________ or ________

A

subcortical white matter, basal nuclei, thalamus

60
Q

_________ is noisy inspiration occuring in coma or deep sleep

A

stertor

61
Q

Stertor is associated with _____________

A

intracerebral hemorrhage (or intraparenchymal hemorrhage)

62
Q

________ is associated with microhemorrhages into the _________ space from damaged blood vessels associated with cerebral contusions

A

traumatic subarachnoid hemorrhage, subarachnoid space

63
Q

traumatic subarachnoid hemorrhage (SAH) is associated with _________ symptamotology and _________________

A

rapidly-developing, blood tracks into sulci and cisterns

64
Q

All __________ form space-occupying lesions that can cause herniation via mass effect

A

intracranial bleeds

65
Q

Headache due to meningeal irritation from blood in CSF is associated with _________

A

traumatic subarachnoid hemorrhage (SAH)

66
Q

The 3 herniation syndromes that can occur with closed head TBI are:

A

subfalcine herniation, central herniation, and uncal herniation

67
Q

A _________ is a type of closed head TBI herniation syndrome that presses the cerebral hemisphere medially against the falx cerebri

A

subfalcine herniation

68
Q

__________ is particularly prominent in acute SDH

A

subfalcine herniation

69
Q

___________ is associated with midline shift and compression of cingulate gyrus, pericallosal and callosomarginal arteries

A

subfalcine herniation

70
Q

__________ is due to pressure from an expanding supratentorial mass lesion on the diencephalon

A

central herniation

71
Q

Mild _________ can produce abducens palsy as compression on VI as it crosses the clivus

A

central herniation

72
Q

Continued expansion of the mass in central herniation after a closed-head TBI can continue to bilateral _____________

A

uncal transtentorial herniation

73
Q

____________ is due to an expanding mass lesion located laterally in one cerebral hemisphere which forces the medial edge of the temporal lobe to herniate over the free tentorial edge into the tentorial notch

A

uncal herniation

74
Q

The _______ can be compressed between the uncus and tentorium in uncal herniation

A

PCA

75
Q

The key sign of _________ is CN III dysfunction (ipsilateral pupil fixed and dilated), decreased consciousness, and hemiplegia

A

uncal herniation

76
Q

The clinical triad of uncal herniation due to closed head TBI is:

A

“blown” pupil, hemiplegia, coma

77
Q

Cheyne-Stokes breathing is common with worsening __________ which affecting the diencephalon

A

uncal herniation

78
Q

Decerebrate posturing is first seen in uncal herniation if it worsens to the point of reaching the _________

A

midbrain (additionally, pupils will be fixed at midpoint and will be non-reactive)

Neuroanatomy Rewind Unit III (9 decks)

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