Week 1 CNS Trauma- Krafts

Question 1

Types of Skull Fractures

Answer 1

Linear- most common, straight crack, usually not serious

Depressed- bone displaced inward, in piece, can damage brain

Diastatic- across a suture, suture widens, usually in children

Basal- more force, distant hematomas, CSF drainage
(Can CSF drainage through nose or ear)- battle sign, raccoon brusing around eyes

Question 2

Define concussion

Answer 2

Altered consciousness from head injury due to change in momentum of head (head hits rigid surface)

Question 3

Symptoms of concussion?

Answer 3

Amnesia, confusion, headache, visual disturbances, nausea, vomitting, dizziness

Question 4

Chronic Traumatic Encephalopathy

Answer 4

• Progressive degenerative disease of the brain
• Athletes/ others with repetitive brain trauma
• behavioral/personality symptoms, then progressive dementia
• Histologically looks like alzheimer

Question 5

Second-Impact Syndrome

Answer 5

Second concussion before first on healed
Brain swells rapidly
Young athletes at greatest risk

Question 6

Direct parenchymal injury

Answer 6

laceration, contusion

Question 7

Coup injury

Answer 7

contusion at point of contact

Question 8

Contrecoup injury

Answer 8

contusion on opposite side

Question 9

Diffuse Axonal injury

Answer 9

injury of axons in deep white matter of brain

twisting/shearing of axons- results in permanent death of the brain cell

caused by angular acceleration/deceleration

“shaken baby” syndrome, boxing

Question 10

Epidural hematoma

Answer 10

blood above dura
tear in middle meningeal artery
hit in temple with baseball
Lucid "ok" period for a little while- characteristic!
Smooth contours on imaging
Neurosurgical emergency!

Question 11

Subdrual hematoma (stays localized, acts like a mass)

Answer 11

Blood between dura and arachnoid- venous rupture!
Shearing of bridging veins
Can be acute( focal symptoms like numbness) or chronic (focal or global symptoms)
Common in elderly falls

Question 12

Subarachnoid Hemorrhage (free flow loss of blood)

Answer 12

Blood in subarachnoid space
-ruptured berry aneurysms (often not trauma, vascular issue) not symptomatic until it blows
“worst headache I ever had” (ON EXAM)
-Neurosurgical emergency!