Thompson 1

Question 1

S/S of brain trauma**

Answer 1

• Raccoon eyes
• battle signs
• Csf/blood in ear canal (or nose)
• skull depression
• penetrating object
• confusion/memory loss
• neuro changes
• vital signs
• mechanisms
• persistent vomiting

Question 2

History tips

Answer 2

• trauma (mech)
• anticoags (any hit to the head along with anticoag gets a CaT)
• change in mental status (confusion/LOC)
• neuro deficits
• what can be explained with intoxication
• personality changes

Question 3

Describe Glasgow model?**

Answer 3

describe mental status

• starts at 3 (dead person)
• normal is 15
• 8 = intubate

Question 4

What triggers brain CT

Answer 4

• ABOVE s/S (any abnormalities)
  
  • give suspecion of brain bleed
• any abnormal neuro exam
• mechanisms
  
  • ejected from vehicle at high speed
• anticoagulants and ANY hit to head
• Too much ETOH on board to evaluate

Question 5

What shows on a CT brain

Answer 5

• CT scan of brain looks for shear injury, bleed, stroke, tumor
• WON’T SHOW A CONCUSSION!!!
  
  • diagnosis of symptoms

Question 6

Subdural hematoma

Answer 6

• Extreme of ages at risk (shaken baby syndrome or old peeps)
• PATH = low pressure venous bleeding of bridging veins… pulls arachnoid away from dura
• blood can cause increase INTRACRANIAL PRESSURE or direct pressure or ishcemia
• MAY CROSS SUTURE LINES
• CRESCENT SHAPE
• usually not associated with skull fx

Question 7

SDH risk factors

Answer 7

trauma especially with LOC

anticoags (fall + anticoags = CT)

hemophiliacs

ETOH abuse

EXTREME AGES (really young and really old)

Question 8

Epidural hematoma

Answer 8

• Bleeding between skull and dural layer –> MOST HAVE SKULL FRACTURES
• 20% “lucid interval” (frequent board question)
  
  • unconscious, wake up and seem normal, then crash
• LESION MORE LOCALIZED, ELLIPITICAL SHAPED (football shape)

Question 9

Subarachnoid hemorrhage (SAH)

Answer 9

• Signs and symptoms:
  
  • headache –> worse of life, sudden “thunderclap” but most have a “prodromal” HA about 2 weeks prior
  • Nausea/Vomiting/photphobia
  • Loss of consciousness
  • Neuro changes in 25%
  • Seizure

Question 10

Large majority are METS from…*****

Answer 10

THESE LIKE TO GO TO THE BRAIN

• Melanoma
• lung
• breast
• colon
• kidney

Question 11

Primary brain tumors

Answer 11

• Cancerous are invasive and aggressive
• while “benign” brain tumors lack those qualities, they can also be life threathening due to limited space in the brain
• BOTH CAN LEAD TO BLEED< STROKE, or SEIZURES, ETC

Question 12

Astrocytoma*

Answer 12

• Originates in the Astrocytes (brain glue)
• number one type of brain cancer in KIDS
• this type as an adult can become undifferentiated (along with other cells like spongioblasts) and is called GLIOBLASTOMA MULTIFORM which is the most common type in adults
  
  • GLIOBLASTOMAS aka glios or GBM

Question 13

How is a glio treated?

Answer 13

• Treated With everything
  
  • surgery
  • radiation (gama knife, cyber knife)
  • chemo
• increasing life span by months is considered successful
• no Cure

Question 14

Pituitary adenoma**

Answer 14

• 3rd most common adult type that causes issues
  
  • MOST common problem hormone disruption (Sex hormones most sensitive, then thyroid and growth hormone)
    
    • Can also have problems with HA or visual changes
• TX surgery
• CURATIVE