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10 Cards in this Set

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  • Back
Most common cause of epidural hemorrhage?
Middle meningeal artery dissection secondary to temporal bone trauma.

Patient is initially lucid and then crashes.
Neuropath of Subdural hematomas
Veins/sinuses attached to dura. Movement can cause tearing and bleed. Post 2/3 of ceberal hemi.

Blood can undergo encapsulation w/fibrovascular membrane. Bleeding risk.
2 Types of Parenchymal Brain Injury
Coup - Stationary head receives linear acc. blow. (contra can occur if severe)

Contra-coup: Moving head hits stationary object. Trauma appears on opposite side of brain.
What is close-head injury?
Occurs from angular acc. blows.

Significant brain damage w/o evidence of scalp/skull/extracerebral hemorrhages. Most common in helmeted cyclists or nailed pedestrians.
What is a gliding contusion?
Most seen in babies (higher water content) White matter split
What is a retraction ball?
Secondary to Diffuse Axonal Injury (DAI). Axonal swelling and transection of fibers.
What are the sequelae of increased ICP?
Cingulate gyrus can cross falx cerebri (ACA compression)

Displacement of cerebral hemisphere pushes uncus and parahippocampal gyrus into post. fossa (PCA and CN III compression). Ipsilateral paresis and contralateral pupil dilatation = Kenohan's notch phenomenon)

Brainsteam displaced caudally = tearing of vessels in midbrain and upper/mid pons. Dorat's hemorrhages. ANY BLEEDING BELOW MID PONS IS NOT FROM INCREASED ICP

Compression of brainsteam = Disruption of cardio-respiratory centers in brainstem.
Where do you see subarachnoid hematomas?
Ventral side of frontal/temporal lobes
Areas affected by contusions
Cingulate gyrus, corpus collosum, white matter, frontal lobes
What kind of hematomas do we see in child abuse?
Subdural. Usually not severe enough to require evacuation. Usually no broken bones.