(Neuro) Cns Trauma

Front 1

Which type of fractures tend to be worse, Linear skull fractures or fractures at the base of the skull?

Back 1

Fractures at the base of the skull are much more severe.

Front 2

Review: What are the layers of the scalp?

Back 2

Remember the mnemonic - SCALP

Skin
Connective tissue
Aponeurosis
Loose areolar
Pericranium

Front 3

(T/F) Scalp injuries may have profuse bleeding but are usually amenable to local control.

Back 3

TRUE

Front 4

What is a major concern with open wounds to the scalp?

Back 4

These wounds can be portals of entry for micro-organisms to reach the brain.

Front 5

Six types of skull fractures:

Back 5

Closed
Depressed
Compound
Compound-comminuted
Basilar
Artifactual

Front 6

What is the major preventable cause of mortality in CNS trauma?

Back 6

Failure to diagnose intracranial hematoma

Front 7

"Which type of hemorrhage is often described as having a ""lucid interval"""

Back 7

Epidural hemorrhage

Front 8

Do epidural hemorrhages usually involve arteries or veins?

Back 8

Arteries

Front 9

Epidural hemorrhages or often associated with a fraction in which part of the skull?

Back 9

Squamous temporal fractions

Front 10

When I say bridging veins, you are thinking of which type of hemorrhage?

Back 10

Subdural hemorrhage

Front 11

Give three predisposing factors for a subdural hematoma?

Back 11

Cerebral atrophy (often caused by age or alcohol)
Coagulopathy
Some trauma (it could be minor [for instance roller coasters])

Front 12

Two mechanisms for how chronic subdural hematomas can enlarge:

Back 12

Osmotic forces
Re-bleeding

Front 13

When you hear the term 'organized - with membranes' which type of hematoma are you thinking of?

Back 13

Chronic subdural hematoma

Front 14

About what percentage of concussions lead to loss of consciousness?

Back 14

About nine percent

Front 15

What is second impact syndrome?

Back 15

When an athlete suffers a concussion and continues to play before the concussion heals.

They have a 3-fold increased risk of suffering a repeat concussion.

Front 16

What type of activity is most associated with contusion hemorrhages?

Back 16

They usually occur secondary to a fall on a moving head (example - getting hit by a moving vehicle)

Front 17

What is a coup hemorrhage? What is a contra-coup hemorrhage?

Back 17

A coup hemorrhage means the lesion is on the same area as where the impact occurred

A contra-coup is located 180 degrees opposite of where the lesion occurred

Front 18

Histologically, how does a contusion hemorrhage differ in appearance from a cerebrovascular accident (CVA)?

Back 18

In a contusion, the hemorrhages are perpendicular to the surface and you see an accumulation of small injuries. Also CVA's tend to be deeper.

Front 19

(From pathology lab) What is a good way to tell the difference in appearance between a coup hemorrhage and a contra-coup hemorrhage?

Back 19

Contra-coup hemmorrhages tend to occur hear the anterior portion of the brain where it is closest to petrous bone.

Also, contra-coup hemorrhages tend to come in pairs and be located bilaterally and symmetrical. There is usually just one coup hemorrhage.

Front 20

All else being equal, which type of gunshot wound would cause more damage - a handgun or a shotgun?

Back 20

Shotgun (long-barreled weapon)

Front 21

What is meant by a temporary cavity when it comes to gunshot wounds to the brain?

What is the significance?

Back 21

As a bullet pierces brain tissue, the surrounding tissue first grows to form a cavity then shrinks.

Clinically, this could cause severe injury although it won't show up on imaging.

Front 22

Amphetamine and cocaine use are associated with which type of hemorrhage?

Back 22

Parenchymal hemorrhage

Front 23

Fractures of long bones containing marrow, resulting in fat emboli can cause which type of hemorrhage?

Back 23

They can cause multiple petechial hemorrhage of white matter (a type of parenchymal hemorrhage)

Front 24

What are diffuse axonal injuries (DAIs)?

Back 24

Traumatic tears of nerve fiber tracts (particularly axons)

Front 25

What is the clinical significance of diffuse axonal injuries (DAIs)?

Back 25

They are considered to be a marker for mortality in whiplash, and abusive head injuries in infants (shaken-baby syndrome)

Front 26

Is immunostaining for diffuse axonal injuries sensitive, specific, or both?

What does this imply?

Back 26

Staining is sensitive, but not specific.

The significance is that if trauma causing DIA did occur, it will very likely show up on the stain. However, other traumatic lesions will also show up.

Front 27

What should you be concerned about when it comes to diffuse axonal injuries in children?

Back 27

They can lead to severe, fatal, rapid-onset edema.

Front 28

Suppose I took a bunch of psycho-active street drugs and as a result I decided it would be a good thing to jump out of a 2nd story window. Suppose I land on my feet but very soon notice I'm paralyzed. Which type of injury did I sustain?

Back 28

A closed spinal cord injury.

Front 29

What are four types of injuries that can lead to a closed spinal cord injury?

Back 29

Falls
Crush injury
Birth injury
Local infection

Front 30

What is a hematomyelia?

Back 30

A hemorrhage into the spinal cord - usually a result of trauma

Front 31

What sort of problems would you expect from a long time boxer?

Back 31

Dementia (post-traumatic encephalopathy)
Abnormal CT scans of cognitive function
Possibly Parkinson's

Front 32

What is spear tackling?

Back 32

A type of tackling in American football where the tackler uses his head to tackle an opponent (like a spear). It can lead to a fatal injury in the tackler (axial loading).

It has sense been banned.

Front 33

What have recent findings from studies on former NFL players and professional wrestlers who've sustained many concussions reveal?

Back 33

Chronic traumatic encephalopathy (from autopsies)
Depression compounded by high levels of chronic pain
Dementia including Alzheimer's disease