Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
22 Cards in this Set
- Front
- Back
what is a concussion?
|
- clinical syndrome characterized by immediate & transient alteration in brain function including AMS
- comes from mechanical or force trauma |
|
what is post concussive syndrome?
|
- symptoms of headache, dizziness, nausea, dysequilibrium, fatigue, impaired memory and irritability that can last for weeks or months after a concussion
|
|
what happens if you have two concussions within a 2 week period?
|
- they are more injurious than having two concussions more than two weeks apart
|
|
what is a coup contusion?
|
- site of impact is directly over contusion
|
|
what is a contracoup contusion?
|
- site of impact is on opposite side of the contusion
|
|
what are typical contusion sites from hitting the back of the head very hard? why is front of head more resistant?
|
- base of frontal lobe & temporal lobe
- front of head is more resistant because sinuses absorb the impact |
|
what is the GCS?
|
- eye opening: 4
- verbal: 5 - motor: 6 - problems with intubated patients is they can't talk so this does not predict their outcome properly |
|
what happens in herniation with an epidural hematoma?
|
- 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 |
|
what is the consequence of tentorial herniation?
|
- duret hemorrhages - infarcts in the midbrain coming from perforators off the basilar artery
|
|
what is Kernohan's notch phenomena?
|
- 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 |
|
what is cephalohematoma? who do you see it in?
|
- 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 |
|
what is a linear skull fracture? when do you worry about it?
|
- 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 |
|
what is a depressed skull fracture?
|
- happens with trauma like kicked in head with horse, hit by baseball bat, etc
- usually don't elevate unless trying to prevent seizure disorder |
|
what happens with an open depressed skull fracture?
|
- always go to OR with these
- gone through dura & now you see brain |
|
what happens with a basilar skull fracture?
|
- 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 |
|
what do Battle's sign & raccoon eyes (a couple days after contusion) indicate?
|
- basilar skull fracture
|
|
what does an epidural hematoma look like?
|
- biconvex
|
|
what happens in an acute subdural hematoma?
|
- more cresent shaped, can spread hemispheric
- bleeding into subdural space |
|
what happens in a chronic subdural hematoma?
|
- 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) |
|
what is diffuse axonal injury?
|
- 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 |
|
what is shaken baby syndrome?
|
- subdural hematoma
- if abuse: can see new & old blood, multiple fractures, retinal hemorrhages (these really only occur with abuse) |
|
what are some treatments for increased ICP in absence of focal mass lesion?
|
- elevate head of bed (try to promote venous return)
- analgesia to try to lower BP - osmotic diuretic, drain CSF - hyperventilation, barbituate coma - consider hemicraniectomy |