Head Trauma

Question 1

concussion

Answer 1

• alteration in cerebral function without pathological changes in brain structure
• immediate impairment of neural function (consciousness, vision, equilibrium)
• transient, mostly reversible less than 6 hours

Question 2

post concussive syndrome

Answer 2

• headache, dizziness, nausea, dysequilibrium, fatigue, impaired memory, irritability
• can last for weeks/months after a concussion

Question 3

after a concussion, wait ___ weeks before returning to sports

Answer 3

after a concussion, wait 2 weeks before returning to sports

• sx should be completely resolved before return
• slowly increase activity again

Question 4

coup contusion

Answer 4

bruise is directly under the impact

Question 5

countercoup contusion

Answer 5

bruise is on the opposite site of the impact

Question 6

glasglow coma score

Answer 6

• scale of 3(worst) -15 (normal)
• grades severity of head trauma
• must have at least 1 point in each category

Question 7

consequence of severe midline shift or tentorial herniation

Answer 7

hemorrhagic infarcts in the midbrain

Question 8

Kernohan’s Notch

Answer 8

• expanded hematoma
• compresses contralateral peduncle
• ipsilateral hemiparesis

Question 9

cephalohematoma

Answer 9

• under periosteum

- calcified bumps

Question 10

linear skull fracture

Answer 10

• usually in kids
• the fracture acts as suture lines, and are pushed apart as the brain grows
• check over time for soft boggy spot

Question 11

depressed skull fracture

Answer 11

• skull indents
• always fix if frontal
• wait to fix if posterolateral

Question 12

open depressed skull fracture

Answer 12

-repair dura, lobe, scalp

Question 13

basilar skull fracture

Answer 13

• hearing loss

- CSF leak

Question 14

Battle’s sign

Answer 14

• temporal bone fracture (basilar skull fracture)

- blood (bruise) collects in mastoid area

Question 15

raccoon eyes

Answer 15

• anterior skull base fracture

- blood collects in eye sockets

Question 16

basilar skull fracture of the temporal bone can lead to _________

Answer 16

basilar skull fracture of the temporal bone can lead to blood/CSF in mastoid air cells

Question 17

epidural hematoma

Answer 17

• middle meningeal artery
• biconvex/lens shaped
• almost all have skull fracture

Question 18

why are epidural hematomas less common in the elderly?

Answer 18

skull and dura kinda fuse together as you get older

Question 19

acute subdural hematoma

Answer 19

• crescent shaped
• holohemispheric
• doesn’t cross midline

Question 20

chronic subdural hematoma

Answer 20

-get older, brain shrinks, easier to break vessels

Question 21

penetrating brain injury

Answer 21

• remove object
• clean up
• don’t need to do too much in brain

Question 22

diffuse axonal injury

Answer 22

-tear white matter tracts, corpus callosum

Question 23

shaken baby syndrome

Answer 23

• non accidental trauma

- causes retinal hemorrhages

Question 24

treatment for increased ICP in absence of a focal mass lesion

Answer 24

• elevate head of bed (venous drainage)
• analgesia, mild sedation
• drain CSF
• osmotic diuretics
• pharmacologic paralysis
• hyperventilation
• barbiturate coma (decrease brain metabolism/blood flow)
• hemicraniectomy