Neuro 2: Trauma Of The Cns

Front 1

Name 3 consequences of a basal fracture?

Back 1

Thinorrhea, Otorrhea, Meningitis (result of the first two)

Front 2

Damage to what lobe is often clinically silent?

Back 2

frontal

Front 3

What type of fx may you not even see by CT?

Back 3

occult

Front 4

Where is KE in a fx dissapated?

Back 4

Suture lines

Front 5

If KE is not dissipated in the suture line; crosses suture line

Back 5

Diastatic

Front 6

Do new fracture lines become diastatic?

Back 6

NO, healing makes the suture lines even stronger

Front 7

When the bone is displaced into the cranial cavity by a distance greater than the thickness of the bone

Back 7

Displaced

Front 8

What type of fracture often occurs when the person is awake and falls?

Back 8

Occipital

Front 9

What type of fracture often occurs when the person faints?

Back 9

Frontal

Front 10

What type of fx often occurs with a blow to occiput or sides of head?

Back 10

Basal

Front 11

What type of fx would you expect if there were symptoms pointing to lower cranial nerves and the presence of orbital or mastoid hematomas distant from the point of impact?

Back 11

Basal

Front 12

Sudden arrest of head by rigid surface

Back 12

consussion

Front 13

What 3 things do you experience with the einstantaneous onset of transient neurologic dysfunction with a concussion?

Back 13

Loss of reflexes (temp), cessation of breathing (temp) and loss of consciousness

Front 14

Do you get a contusion with a concussion?

Back 14

no

Front 15

What is the biochemical foundation of a concussion?

Back 15

Ca enters the cells and poisons the mito

Front 16

What would you see in a football player with chronic traumatic encephalopathy?

Back 16

Brain flecked with brownish tau proteins

Front 17

What are two types of direct parenchymal injury?

Back 17

Contusions and lacerations

Front 18

In a contusion of the brain, where would the wedge shaped part face?

Back 18

Point of impact

Front 19

Name 2 causes of a SAH?

Back 19

contusion in parenchymal and Berry aneurysm

Front 20

Where would you find blood in a direct parenchymal contusion?

Back 20

White and Gray matter and in SAS

Front 21

Will you see ischemia in a contusion?

Back 21

yes

Front 22

Will there be neutrophils and mac in a contusion?

Back 22

yes

Front 23

Where will you see a plaque jaune?

Back 23

over the site of the bruise.

Front 24

Why is a plaque jaune yellow?

Back 24

breakdown of heme into billirubin

Front 25

What is the cavitation due to in a contusion?

Back 25

liquefaction necrosis due to ischemia and macrophages eating myelin/fat/iron

Front 26

Where are the most common places to get a direct parenchymal injury?

Back 26

Floors of anterior and middle fossae (they are rough)

Front 27

Cerebral injury at the point of contact

Back 27

Coup

Front 28

Damage to brain surface opposite to point of contact

Back 28

Contracoup

Front 29

What may also result in avulsion?

Back 29

parenchymal injury

Front 30

What injury would occur when the head is fixed?

Back 30

skull fx

Front 31

Free standing, hit with a hammer. Brain wants to stay where it is, but skull moves

Back 31

Moveable injury (Coup)

Front 32

What is the head doing during a coup injury?

Back 32

it is immobile, but may be during moveable injury

Front 33

What is caused by the force of direct impact between the brain and skull at the site of impact?

Back 33

Coup

Front 34

Falling, brain lags behind

Back 34

Moving injury

Front 35

What is the head doing during a contracoup injury?

Back 35

head is mobile

Front 36

Develops when the brain strikes the opposite inner surface of the skull after sudden deceleration

Back 36

Contracoup injury

Front 37

Fibers from the F to O and F to T break

Back 37

Rotational injury

Front 38

Where will you see axonal swelling>

Back 38

direct parenchymal injury and diffuse axonal injury (DAI)

Front 39

Where will you see focal hemorrhagic lesions (petichiae) and axonal swelling?

Back 39

DAI

Front 40

What region of the brain does a DAI occur?

Back 40

Supratentorial (corpus callosum, hippocampus, periaqueductal) and brainstem, peduncles, colliculi and deep reticular formation

Front 41

What is DAI NOT associated with?

Back 41

low falls, fx, contusions, hematomas, SAH

Front 42

Where will you see NO lucid moment?

Back 42

DAI (coma from moment of insult)

Front 43

Where do most DAI occur in the brain?

Back 43

Where gray and white matter meet

Front 44

What type of injury will you see axonal swellings that look like thin hair?

Back 44

DAI (elastic has come back from stretching)

Front 45

Where will you see retraction balls?

Back 45

DAI (axons that come back from being stretched)

Front 46

Where is the specific injury to axons in a DAI?

Back 46

nodes of Ranvier

Front 47

What are two common types of DAI?

Back 47

car accidents and rotational injuries (boxing)

Front 48

Where will you see cessation of flow of axoplasm up and down?

Back 48

DAI (injury to nodes of Ranvier)

Front 49

What traumatic vascular injury would you see a lucid moment?

Back 49

Epidural Hematoma

Front 50

Epidural hematomas are usually caused from tears in what

Back 50

arteries in the dura (esp middle meningeal)

Front 51

What hematoma will be smooth and convex?

Back 51

Epidural hematoma

Front 52

Tearing of what causes a subdural hematoma?

Back 52

veins between arachnoid and dura

Front 53

The elderly are more prone to what type of traumatic vascular injury and why?

Back 53

Subdural hematoma due to atrophy

Front 54

A tear where is characteristic of a subdural hematoma?

Back 54

junction of veins and sinus

Front 55

Where does a hematoma clinically manifest within 48 hours of injury?

Back 55

Subdural hematoma

Front 56

What part of the hemisphere do most subdural hematomas occur?

Back 56

lateral

Front 57

Confusion in a subdural hematoma would be what?

Back 57

Nonlocalized

Front 58

Where would you see a "pita pocket" and why?

Back 58

subdural hematoma because the lesion is attached to dura by fibrous tissue (not to arachnoid)

Front 59

Where would a clot lyse, but fibroblasts grow into a hematoma?

Back 59

Subdural hematoma

Front 60

Why is rebleeding common with a subdural hematoma?

Back 60

Neovascularization with fibroblasts

Front 61

What can a basal ganglion contusion from a high speed car accident case?

Back 61

Intraparenchymal Hemorrhage

Front 62

What is an intraparenchymal hem associated with?

Back 62

Laceration, surface contusions, and high speed car accidents (basal gaglion contustion)

Front 63

Where would you see Spat Apoplexie (Late Stroke)

Back 63

Intraparenchymal hemorrhage

Front 64

What is a rare, deep hem that may follow minor trauma?

Back 64

Spat Apoplexie (Intraparenchymal hem)

Front 65

What type of hydrocephalus can occur in an organizing SAH?

Back 65

Communicating

Front 66

Repetitive injuries

Back 66

demential pugilistica (punch drunk)

Front 67

SC lesion above C4

Back 67

quadriplegia, diaphragmatic paralysis

Front 68

SC lesion below C4

Back 68

isolated tract damage

Front 69

Hour glass lesion

Back 69

ascending/descending tract degeneration

Front 70

What type of lesion in SBS?

Back 70

SAH (Gliding lesion)