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10 Cards in this Set

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What is the leading cause of death in <24yo?

What is a primary brain injury?
Secondary brain injury?

What type of brain injury do impact forces cause?

Inertial (accel/decele)?
trauma. 50% of those are head trauma.

- mechanical damage occuring @ moment of impact
- effects of mass lesions, cerebral ischemia, brain swelling

contact/focal brain injury

diffuse brain injury from stretching or shearing of axons and blood vessels
What are associated w/ skull fracture and tearing of a meningeal artery (usually the middle one)?
- can they also be caused by venous tearing?
- presentation on CT?
- do pts have a lucid interval before mass effect --> coma?
epidural hematomas
- yes
- "lens" shape w/o crossing sutures
- yes, ~25% do.
What are the 3 classifications of subdural hematoma?
- some predisposing factors?
- can they cause mass effects?
- associated with tearing of what?
- appearance on CT?
acute (0-2d), subacute (3-20d), chronic (21+)
- age-related brain atrophy, alcoholism, coagulopathy, anticoag, overdrainage by shunt
- yes, and herniation
- cortical and leptomeningeal arteries and veins... usually a "bridging vein"
- "gloopy" stuff, a little more spread from the biggest mass... a little irregular.
Differentiate b/t contre-coup and coup contusions --> cortical hemorrhage.
coup: hemorrhage on same side as imapct
contre: hemorrhage on opposite side.
What is the the most common cause of coma in absence of an intracrainiall hematoma?

Most common cause of severe disability post head injury?
DAI (diffuse axonal injury)
What is the gross path of DAI?
focal hemorrhages in corpus callosum and dorsolateral quadrants of rostral brainstem (region of superior cerebellar peduncle). May also see focal intracerebral hemorrhages elsewhere in brain.
What is the histopathology of DAI?
damaged axons develop axonal swellings (“retraction bulbs”), which can be highlighted with an immunohistochemical stain for amyloid precursor protein (APP). The APP, which normally travels via anterograde axonal transport, accumulates in the axonal swellings.
Describe shaken baby syndrome.
Infants less than 3 years old with few or no external injuries

Subdural hematomas, often bilateral and often small

Retinal hemorrhages

Brain swelling
What are some common post-concussive sx?
- is recovery complete?
LOC, temporary respiratory arrest, loss of deep tendon reflexes
- yes.
What areas are most affected by acceleration-deceleration injuries causing DAI?
deep white matter tracts of the cerebrum (like the corpus callosum)