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19 Cards in this Set
- Front
- Back
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In what proportion of people are extradural haematomas associated with a fracture?
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95% of adults, 75% of kids
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In what proportion of people are extradural haematomas associated with a fracture?
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>80% of acute SDH: fracture of cranial vault or base of skull
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Appearance of subdural haematomas on CT
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Acute < 3d- hyperdense
subacute: 4-21d - isodense chronic >21d - hypodense |
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What % of chronic SDH are bilateral?
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25%
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Management of chronic SDH?
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drain through burrholes
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Indications for CT after head trauma?
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Altered level of conc/drowsy
neuro deterioration CSF rhinorrhea Associated injuries that will lead to prolonged intubation so that ongoing assessment will be difficult |
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Management of minor head injuries
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observe for 4 hours then discharge unless meets criteria for admission to hospital
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criteria for admission to hospital after head injury?
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LOC/amnesia for > 10 minutes
Persistent drowsyness focal neuro sx Skull fracture nausea and vom > 4hrs Lack of care at home |
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management of compound skull fracture?
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debride and close + short course of prophylactic antibiotics
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Most common genetic defect found in intracranial neoplasms?
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p53 mutation: found in astrocytomas and menigeomas
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Time-course of GBM presentation
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rapid worstening over weeks-months
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Appearance of low grade glioma on CT?
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decrease indensity
also decrease in intensity on T1 MRI non-contrast enhancing: high grade will contrast enhance |
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Prognosis after surgery for GBM
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17 weeks
37 weeks with RT chemo marginally increases survival but still < 1 year |
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Characteristic of oligodendroglioma on imaging?
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calcium deposits
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Management of oligodendroglioma
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depends on grade- very low grade can be conservatively managed with serial imaging\Established role for chemo especially in those with loss of heterozygosity on chrom 1p or 19q
Most patients develop or present with seizures- so anticonvulsive rx indicated |
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1 year survival of brain metastases
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50% breast cancer primary
30% lung cancer primary 30% if melanoma is primary 50% of unknown primary- 15% of metastases |
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Management of brain mets
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steroids
surgery if solitary and accessable - and primary can be controlled/causing significsnt sx, may follow with RT Multiple: RT + steroids Steriotactic radiosurgery |
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When can steriotactic radiosurgery be done?
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multiple/single cerebral mets if tumour size < 3cm
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How common are paediatric brain tumours?
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most common solid tumours of childhood
60% are infratentorial |
