Unit 2: TBI and Stroke Flashcards
L1: Which pathologic finding? Concussion with catastrophic cerebral congestion and increased intracranial pressure due to pathologic dysregulation of intracranial vessels
Second Impact Syndrome
L1: Which pathologic finding? Downward pressure centrally that causes bilateral uncal herniation
Central herniation
L1: Which pathologic finding? Intracraial bleeding resulting from tearing of bridging veins that connect the cortical surface to the sagittal sinus
Subdural Hematoma
L1: Which pathologic finding? Protrusion of the cerebellar tonsils down into the foramen magnum, which can produce Cushing’s reflex by medullary compression
Tonsillar herniation
L1: Which pathologic finding? Uncus crosses the tentorial edge and pushes into the posterior fossa, compressing on midbrain, cerebral peduncle, and ispilateral, oculomotor nerve
Uncal herniation
L1:Which pathologic finding? Intracranial bleeding frequently resulting from fractures near the middle meningeal artery
Epidural Hematoma
L2: ______ infarcts appear on Diffusion Weighted Imaging (DWI) MRI.
New
L2: ______ infarcts appear on FLAIR T2-weighted MRI.
Old
L2: Imaging protocol for suspected stroke: _______ > _______ > ________
Noncontrast CT; Perfusion CT; CT angiogram
L2: On CT scan, hemorrhagic strokes appear _____ (whiter/darker), or more radio______, than surrounding brain tissue.
whiter; -paque
L2: On CT scan, ischemic strokes appear _____ (whiter/darker), or more radio_____, than surrounding brain tissue.
darker; -lucent
L2: On MRI, infarcts appear ______.
white
L2: On perfusion CT, at-risk tissue shows _____ time to perfusion, ______ time to peak, and ______ blood flow
increased; increased; normal
L2: On perfusion CT, completed infarcts show ______ time to perfusion, _______ time to peak, and ______ blood flow
increased; increased; decreased
L2: Surgical Treamtment for ischemic strokes
Endarterectomy
L2: Treatment for hemorrhagic stroke prevention
Aneurysm clipping or coiling
L2: Treatment for ischemic stroke resuscitation
t-PA
L2: What is a sign visible on imaging that demonstrates axonal injury has occurred?
Hemorrhage
L2: Which pathologic finding? A brief episode of neurologic dysfunction caused by focal brain or retinal ischemia with clinical symptoms typically lasting less than one hour, without evidence of acute infarction
Transient Ischemic Attack (TIA)
L2: Which pathologic finding? Arterial media hyptrophy that can result or occlusion or stenosis, commonly in the carotid artery
Fibromuscular Dysplasia
L2: Which pathologic finding? Associated with arterial dissection and intracranial saccular aneurysms
Fibromuscular Dysplasia and Moya Moya Disease
L2: Which pathologic finding? Can cause a duret hemorrhage in which the ascending reticular activating system is disrupted
Uncal herniation
L2: Which pathologic finding? Cingulate gyrus is pushed away by a mass effect and herniates beneath the falx cerebri
Subfalcine herniation
L2: Which pathologic finding? Edema resulting from brain swelling due to breakdown of the blood-brain barrier
Vasogenic edema
L2: Which pathologic finding? fixed focal neurological deficit attributable to arterial or venous territory, typically lasting longer than 24 hours with evidence of acute infarction
Ischemic Stroke
L2: Which pathologic finding? Focal occlusion of the middle cerebral artery due to intimal hyperplasia
Moya Moya Disease
L2: Which pathologic finding? Intracranial bleeding resulting from translational acceleration changes
Subdural Hematoma
L2: Which pathologic finding? Intracranial bleeding that occurs on the rough bony surface of the anterior fossa or along the edge of the sphenoid greater wing
Subdural Hematoma
L2: Which pathologic finding? No gross findings on CT, retraction balls on microscopic analysis
Diffuse Axonal Injury (DAI)
L2: Which pathologic finding? Presents following injury with a lucid interval followed by progressive obtundation and coma
Epidural Hematoma
L2: Which pathologic finding? Presents with severe short-onset headache with mortality in the majority of patients
Subarachnoid hemorrhage
L2: Which pathologic finding? Results from high velocity rotational acceleration injury
Diffuse Axonal Injury (DAI)
L2: Which pathologic finding? Stroke most commonly occurring in the basal ganglia, thalamus, pons, or cerebellum
Intracranial hemorrhage
L2: Which pathologic finding? Swelling of astrocytes in response to extracellular hyperkalemia and high potassium uptake
Cytotoxic edema
L2: Which pathologic finding? Type of stroke most commonly caused by trauma and ruptured aneurysm in atraumatic patients
Subarachnoid hemorrhage
L2: Which vascular involvement? Stroke resulting in lower extremity numbness and weakness
Anterior cerebral artery
L2: Which vascular involvement? Stroke resulting in upper extremity asymmetric weakness
Middle cerebral artery
L2: Which vascular involvement? Stroke with acute onset movement disorders of asymmetric distribution
Small vessels
L2: Which vascular involvement? Stroke with coma
Basilar artery
L2: Which vascular involvement? Stroke with vision disturbances
Posterior cerebral artery
L3: Domains of Scoring in the Glasgow Coma Scale
Eye Opening, Motor Response, Verbal Response
L3: Mechanisms of reducing intracranial pressure (3)
osmotic diuretic (mannitol), drain CSF, induce coma (barbiturates)
L3: New infarcts appear on ______ MRI.
Diffusion-Weighted Imaging (DWI)
L3: Old infarcts appear on ________ MRI.
FLAIR T2-weighted
L3: Treatment for ischemic stroke prevention (3)
Aspirin, thienopyridines, anticoagulants
