Head Injury and Coma Flashcards Preview

Neurology > Head Injury and Coma > Flashcards

Flashcards in Head Injury and Coma Deck (41)
Loading flashcards...
1
Q

“Any trauma to the brain or scalp”???

A

Head Injury

2
Q

“Damage to the brain, which occurs after birth and is not related to a congenital or a degenerative disease”

A

Acquired Brain Injury

3
Q
  • Stroke
  • Tumour
  • Infection
  • Anoxia

are examples of ???

A

Non-Traumatic Brain Injury

4
Q

“A non-degenerative, non-congenital insult to the brain

from an external mechanical force”

A

Traumatic brain injury

5
Q

What % of TBI’s are Males?

A

70%

6
Q

what % of TBI’s are children under 15 years of

age?

A

33-50%

7
Q

Who’s at higher risk of TBI?

A
  • young males
  • previous head injuries
  • Alcohol an drug abuse history
  • Low- income
8
Q

Which is the most common?

A. Crushed head injurys
B. Open or Penetrating head wounds
C. Closed head injuries

A

C.

9
Q

Crush injuries often damage…?

A

The base of skull and nerves of brain stem rather than brain itself

10
Q

-cerebral oedema
-seizures
-haematoma
-increased intracranial pressure (ICP)
are examples of…?

A

Secondary damage:

Damage that evolves over time after trauma.

11
Q

What does ATLS stand for?

A

Advanced Trauma Life Support

12
Q

In ATLS what does ABCDE stand for?

A
  • Airway maintenance and Cervical Spine Protection
  • Breathing and Ventilation
  • Circulation and haemorrhage control
  • Disability – neurological status: GCS, pupils
  • Exposure – undress the patient
13
Q

If someone is scored 10 on the GCS what catagory would that place them in?

A

‘moderate’

14
Q

If someone is scored 4 on the GCS what catagory would that place them in?

A

‘critical’

15
Q

-An area of localized injury that may cause pressure
within the brain.
-Sometimes called ‘mass lesions’.

what is this?

A

Focal Injuries

16
Q

What are the two main types of focal injuries?

A

Traumatic Haematoma or Contusion

17
Q

A. • Collection of blood in ‘potential’ space between
skull and outer protective lining that covers the brain.
B. • Collection of blood in space between dura mater and arachnoid mater

Which one describes a Subdural Haematoma?

A

B.

18
Q
  • Blood vessel within brain bursts, allowing blood to leak inside brain
  • Sudden increase in pressure can cause damage to surrounding brain cells

What is this?

A

Intracerebral Haematoma

19
Q

Which of the following is not typical of Contusions?

A. Comparable to bruises in other parts of the body - areas of injured or swollen brain mixed with blood that has leaked out of arteries, veins, or capillaries.

B. Caused by small blood vessel leaks, usually most evident on scans after 24 hours

C. • May occur with or without an associated focal injury

D. Most commonly seen at the base of the front parts of the brain, but may occur anywhere

A

C. - that’s typical of diffuse axonal injuries

20
Q

“Results from brain moving back and forth in skull as a result of acceleration or deceleration”
“One of the most common types of brain injuries, also one of the most devastating”

What is this?

A

Diffuse axonal injury

21
Q

With head injury – what injury should be assumed until proven otherwise?

A

Cervical Spine Injury

22
Q

If a fracture extends into the sinuses, there may be leakage of what from the nose or ears?

A

CSF (Cerebro-Spinal Fluid)

23
Q
  • A build-up of fluid inside the skull that leads to brain swelling
  • A build up of blood inside the skull that leads to brain swelling
  • A blockage inside the skull that leads to brain swelling

which of these describes Hydrocephalus?

A

A build-up of fluid inside the skull that leads to brain swelling….

…It puts pressure on the brain pushing the brain up against the skull and damaging brain tissue

24
Q

Why can Hydrocephalus occur?

A
  • The flow of CSF is blocked.
  • The fluid isn’t properly absorbed into the blood.
  • Overproduction of the fluid
25
Q

How can raised IntraCranial Pressure be managed medically?

A

▪ Sedation
▪ Maximise Venous Drainage of Brain
▪ CO2 control
▪ CSF release

26
Q

Why might a External Ventricular Drain be used?

A
  • to relieve raised intracranial pressure
  • to divert infected CSF
  • to divert bloodstained CSF following neurosurgery
  • to divert the flow of CSF
27
Q

A• Small holes drilled in the skull and a tube is inserted
to drain the haematoma and relieve pressure

B• An operation where a disc of bone is removed from
the skull to allow access to the underlying brain.
• After the surgery the bone is replaced

C• If the brain is very swollen the bone isn’t
replaced until the swelling decreases, which
may take several weeks.

Which describes Craniotomy?

A

B.

28
Q

A• Small holes drilled in the skull and a tube is inserted
to drain the haematoma and relieve pressure

B• An operation where a disc of bone is removed from
the skull to allow access to the underlying brain.
• After the surgery the bone is replaced

C• If the brain is very swollen the bone isn’t
replaced until the swelling decreases, which
may take several weeks.

Which describes Burr Holes?

A

A.

29
Q

A• Small holes drilled in the skull and a tube is inserted
to drain the haematoma and relieve pressure

B• An operation where a disc of bone is removed from
the skull to allow access to the underlying brain.
• After the surgery the bone is replaced

C• If the brain is very swollen the bone isn’t
replaced until the swelling decreases, which
may take several weeks.

Which describes Craniectomy?

A

C.

30
Q
  • GCS 8 or less
  • Inability to eye open, verbalise or obey
  • No sleep / wake cycle
  • No voluntary movements

What is this?

A

A coma.

31
Q

What two systems regulate and control consciousness?

A
  1. The Cerebral Cortex

2. The Reticular Activating System

32
Q

What are functions of the Cerebral Cortex?

A
  • Perception
  • Sensation (via thalamus)
  • Movement
  • Vision
  • Thought
33
Q

What does the Reticular Activating system control?

A
  • Arousal
  • Sleep
  • Awakening
34
Q

What does the Pons (brainstem) do?

A

-Contains nuclei that relay signals from the forebrain to the cerebellum
-nuclei that deal primarily with sleep, respiration, swallowing, bladder
control, hearing, equilibrium, taste, eye movement, facial expressions, facial
sensation, and posture

35
Q

which part of the brainstem is associated with vision, hearing, motor control, sleep/wake, alertness, and
temperature regulation?

A

The Midbrain.

36
Q

Which part of the brainstem contains the cardiac, respiratory, vomiting, and regulate involuntary functions such as breathing, heart rate, and blood pressure?

A

The Medulla.

37
Q

Which cause of coma has a better prognosis?

  • Hypoxia/Ischaemia
  • Haemorrhage/Stroke
A

neither are good prognosis.
-Hypoxia/ Ischaemia has a better prognosis however (<10% chance of recovery)

(Haemorage has a <5% chance of recovery)

38
Q

after over 24 hours coma, whats the % prognosis?

A

10% chance of recovery

39
Q

prognosis after 7 days in coma?

A

3% chance of recovery

40
Q

Whats the difference between brain death and a vegitive state?

A
  • When someone is brain dead they have no arousal or awareness
  • when someone is in a vegitive state they have no awareness but do have arousal
41
Q
  • Unconscious and no response to outside stimulation
  • Heartbeat and breathing can only be maintained using a ventilator
  • Clear evidence that serious brain damage has occurred and it can’t be cured

what diagnosis might be made from this?

A

Brain stem death.