Lecture 16 highlights

Question 1

What is the mnemonic for the layers of the scalp?

Answer 1

SCALP
Skin and dense Connective tissue
epicranial Aponeurosis
Loose areolar connective tissue
Periosteum

Question 2

What does the cranial vault consist of?

Answer 2

1) Frontal bone
2) Parietal bone
3) squamous portion of Occipital bone
4) greater wings of Sphenoid bone
5) Temporal bones (squamous portion)

Question 3

Differentiate primary and secondary TBIs

Answer 3

Primary = at time of injury
Secondary = brain’s response to injury

Question 4

What are imaging options for TBIs?

Answer 4

STAT noncontrast CT head, but if vascular concern, conventional angiography is gold standard
(CTA is also an option)

Question 5

What imaging for basilar skull Fxs?

Answer 5

CT head w/o contrast

Question 6

What is an emergency procedure of Penetrating injury & GSWs of the skull?

Answer 6

Craniotomy

Question 7

What are some key traits of Cerebral Contusions?

Answer 7

Non-space occupying, but edema possible
CT head w/o contrast for imaging

Question 8

What is the gold standard for ICP monitoring?

Answer 8

Intraventricular catheter connected to a standard pressure transducer

Question 9

Intracranial hematomas:
1) MC cause?
2) Types? (4)

Answer 9

1) Traumatic rupture of blood vessels
2) Epidural hematoma
Subdural hematoma
Subarachnoid hemorrhage
Intraparenchymal hemorrhage

Question 10

Epidural hematoma (EDH):
1) MC cause?
2) What is a unique trait of these pts?

Answer 10

1) Dural artery laceration
2) Lucid intervals

Question 11

What is the mainstay of surgical Tx for EDHs?

Answer 11

standard craniotomy over EDH for hematoma evacuation

Question 12

Subdural hematoma (SDH):
1) MC cause?
2) CT head w/o contrast finding?

Answer 12

1) Bridging veins rupture
2) Crescent shape

Question 13

What is the main operative approach for acute SDH?

Answer 13

Large craniotomy

Question 14

Subarachnoid hematoma/ hemorrhage (SAH):
1) What is it?
2) MC cause?

Answer 14

1) Collection of blood in subarachnoid space
2) Trauma

Question 15

What is the gold standard for dx presence of aneurysm after SAH?

Answer 15

cerebral angiography

Question 16

Intraparenchymal hematoma: What is the MC cause?

Answer 16

Coup or contrecoup injury

Question 17

Descr normal vs pathologic ICP

Answer 17

Normal adult ICP < 15 mm Hg
Pathologic ICP > 20 mm Hg

Question 18

What are 2 reasons for surgical intervention in SCIs?

Answer 18

decompression & stabilization

Question 19

1) Conus medullaris syndrome: What level?
2) What level is cauda equina?

Answer 19

1) T12-L2
2) L1-L5 (but saddle anesthesia S3-S5)