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Lecture 14
Trauma of the Central Nervous System
| Question | Answer |
|---|---|
| What is the leading cause of CNS injury for ages <15 and >65? | Falls |
| What is the leading cause of CNS injury for adolescents and young adults? | Motor vehicle accidents |
| A type of skull fracture distant from the point of the impact and not a direct extension of hte original fracture. | Coutercoup fracture |
| Most common location of contusions | (1) inferior surface of the frontal lobes (2) inferior and lateral aspects of the temporal lobes (3) occipital lobes |
| What vessel is injured in an epidural hematoma? | Middle meningeal artery |
| Why do epidural hematoms necessitate emgergent surgical intervention? | Epidural hematomas cause acute compression and displacement of the underlying brain with high morbidity and mortality. |
| What is the appearance of an epidural hematoma on CT scan? | Epidural hematomas have a "lens-shape" or biconvex shape. The hematoma does not cross over suture lines. |
| What vessels are injured in a subdural hematoma? | Bridging veins: veins that travel from the brain surface to the dural sinuses within the subdural space. |
| What is the appearance of an subdural hematoma on CT scan? | The subdural hematoma have a "crescent-shape" mass that crosses over suture lines. |
| What vessels are injured in a subarachnoid hemorrhage? | Cortico-meningeal arteries |
| What vessels are injured in intraparenchymal hematomas? | Small intraparenchymal vessels |
| A common cause of persistent neurological disability. The injury usually results form mechanical distorition and/or stretching of axonal processes and microvasculature from brain motion. | Diffuse Brain Injury |
| Common locations of diffuse axonal injury | (1)cerebral hemisphere white matter (2)corpus callosum (3)subcortical fiber tracts(fornix, internal and external capsules), brain stem |
| Histological features of diffuse axonal injury | (1)axonal retraction balls (2)axonal swelling (3)focal glial scarring in chronic phases |
| Common locations of diffuse vascular injury | Similar locations to diffuse axonal injury: (1)hemispheric white matter (2)corpus callosum (3)brain stem (4) superior cerebellar peduncles |
| Histologic features of diffuse vascular injury | In the acute phase: small (petechial) hemorrhages. In the chronic phase: cystic lesions with glial scarring |
| (T or F) The extent of injury by a gunshot wound to the head primarily depends on the velocity of the bullet, with higher-velocity bullets causing the greatest amount of damage. | True. |
| (T or F) The exit wound is typically greater than the entrance wound if the barrel of a gun is immediately adjacent to the head. | False. The entrance wound is greater than the exit wound if the barrel is against or immediately adjacent to the head. |
| (T or F) Majority of spinal cord injury victims are males with the median age of 33 years. | True. 80% are males and 50% of patients are <25 years. |
| A focal crush and compression, flexion or extension of hte spinal cord by fracture or fracture dislocation of the spinal cord. | Closed spinal cord injuries |
| Common locations of ischemic brain damage after head trauma | (1) hippocampus CA1(Sommer's sector), Purkinje cells of cerebellum (3) Arterial boundry zones (watershed infarcts) |
Created by:
UVAPATH2
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