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22 Cards in this Set
- Front
- Back
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what is a concussion?
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- clinical syndrome characterized by immediate & transient alteration in brain function including AMS
- comes from mechanical or force trauma |
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what is post concussive syndrome?
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- symptoms of headache, dizziness, nausea, dysequilibrium, fatigue, impaired memory and irritability that can last for weeks or months after a concussion
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what happens if you have two concussions within a 2 week period?
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- they are more injurious than having two concussions more than two weeks apart
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what is a coup contusion?
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- site of impact is directly over contusion
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what is a contracoup contusion?
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- site of impact is on opposite side of the contusion
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what are typical contusion sites from hitting the back of the head very hard? why is front of head more resistant?
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- base of frontal lobe & temporal lobe
- front of head is more resistant because sinuses absorb the impact |
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what is the GCS?
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- eye opening: 4
- verbal: 5 - motor: 6 - problems with intubated patients is they can't talk so this does not predict their outcome properly |
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what happens in herniation with an epidural hematoma?
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- get more & more lethargic, dilate the ipsilateral pupil b/c compressing CN III b/c of tentorial herniation
- then enough herniation occurs that the second pupil dilates and then it is too late & midbrain infarcts and you die |
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what is the consequence of tentorial herniation?
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- duret hemorrhages - infarcts in the midbrain coming from perforators off the basilar artery
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what is Kernohan's notch phenomena?
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- dilated left pupil ipsilateral = left brain
- paralysis on the left side --> kernohan's notch because the midline shift compresses the right brain so you get left hemiparesis |
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what is cephalohematoma? who do you see it in?
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- don't see this in anyone other than newborns
- get it coming through the birth canal - bleeding right under periosteum, usually don't treat because you can lay down bone on top of hematoma & resorb it - can become calcified cephalohematoma |
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what is a linear skull fracture? when do you worry about it?
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- can happen in infants
- worry about it when it becomes a GROWING SKULL FRACTURE because it keeps pushing apart and doesn't heal on it's own |
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what is a depressed skull fracture?
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- happens with trauma like kicked in head with horse, hit by baseball bat, etc
- usually don't elevate unless trying to prevent seizure disorder |
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what happens with an open depressed skull fracture?
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- always go to OR with these
- gone through dura & now you see brain |
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what happens with a basilar skull fracture?
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- specific fracture at base of skull
- can get carotid dissection & get horners - can also translate to the ethmoid bone, frontal sinuses & sphenoid sinuses & end up with CSF leak |
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what do Battle's sign & raccoon eyes (a couple days after contusion) indicate?
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- basilar skull fracture
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what does an epidural hematoma look like?
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- biconvex
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what happens in an acute subdural hematoma?
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- more cresent shaped, can spread hemispheric
- bleeding into subdural space |
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what happens in a chronic subdural hematoma?
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- does not always happen from acute
- happens in very young or very old - when older on warfarin brain gets atrophic so subdural space opens up --> separation of dura & arachnoid, get need blood vessels growing & they bleed into themselves --> sometimes can happen after minor injury (4-8 weeks) |
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what is diffuse axonal injury?
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- rapid accelerating or decelerating injury with spinning end up with diffuse axonal injury
- CT normal but patient comatose, can see on MRI corpus callosum ripped apart |
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what is shaken baby syndrome?
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- subdural hematoma
- if abuse: can see new & old blood, multiple fractures, retinal hemorrhages (these really only occur with abuse) |
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what are some treatments for increased ICP in absence of focal mass lesion?
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- elevate head of bed (try to promote venous return)
- analgesia to try to lower BP - osmotic diuretic, drain CSF - hyperventilation, barbituate coma - consider hemicraniectomy |
