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Brain Injury
| Question | Answer |
|---|---|
| Who is the most at risk for brain injuries? | Single males under the age of 30. |
| How many people suffer from brain injury a year? | 500 000 |
| What role do neuropsychologists play? | assessing survivors and providing rehab |
| what are the pathomechanisms of head injury? | physical forces placed on the neuron, specifically the axon and the cell body which has a shearing and tearing affect at the neuron level |
| What may brain trauma do to the brain? | it may deform, stretch and compress the brain and its tissue , exceeding normal tissue extendability, particularly along the neuron |
| What leads to cell death? | When forces tear the axon and it degenerates back into the cell body |
| How do physical changes at the cellular level affect the person? | Can lead to cognitive defects |
| What are these types of degeneration likely to result from? | Rapid acceleration and deceleration |
| Can neurons resprout new axonal projections? | yes only if the neurons are not completely severed |
| What are the two types of head injury? | Penetrating head injury and closed head injury |
| When does a penetrating head injury occur? | when a small object has lodged in the brain |
| What are the 2 factors that make penetrating head injuries very dangerous to the cortical integrity of the brain? | 1) location and extent of damage 2)complications such as infection and hemorraging |
| What are the most common causes of closed head injury? | When the brain undergoes a marked acceleration or deceleration |
| What are the physical forces acting on the point of impact or opposite pole called | coup and counter coup |
| Where is diffuse injury post likely to take place? | frontal and temporal lobes because of the uneven sandpaperlike surface of the tentorial plates that hold the brain structure in place |
| What test is used to asses the severity of the brain injury? | Glascow Coma Scale |
| What aspects does this tests assess? | language, consciousness and motor domains |
| Medically a coma is defined as a score of? | 8 or less - cannot open eyes, make any recognizable sounds and follow any commands |
| What is a reliable measure of overall level of brain damage and prognosis | depth of coma and posttraumatic amnesia |
| Coma is typically associated with injury to which parts of the brain? | lower brain stem and the reticular activating system that are involved in the brain's arousal |
| limitations of glascow coma scale | 1) incorrect assessment because of injury 2) small lesion in the brain stem leads to loss of consciousness but there is no brain damage |
| What are the possible complications of moderate to severe brains injury? | oedema, heriniation, intracranial bleeding and skull fractures |
| What is the swelling of the brain called? | oedema |
| Why is swelling of the brain a problem? | there is no place to swell into and as a result internal pressures increase |
| What is used to monitor intracranial pressure? | intracranial monitoring cathator that is placed into the ventricles of the subarachnoid space |
| What can intracranial pressure cause? | diffuse brain injury and even death |
| What is brain herniation? | increasing intracranial pressure often related to a large pocket of blood |
| What is a hematoma? | A large pocket of blood |
| What is the only large opening in the skull? | foramen magnum |
| Where does a brain herniation place extreme pressure? | brain stem, often cutting off the cranial nreve 3 |
| What happens if a herniation is left untreated? | person goes into coma and dies of respiratory failure because the medulla obligata has been damaged |
| WHat does oedema process into? | Brain herniation |
| What is the main medical issue in acute brain injury? | controlling ICP |
| How is ICP treated? | lowering patients blood pressure, including an artifical coma and evacuation |
| What is a haemorrhage? | as a result if head injury, cerebral blood vessels may tear, producing pools of blood within and between mengies |
| What happens iff a person has a subdural haematoma? | initial period of unconsciousness, bleeding delay, normal consciousness, oncel bleed enlarges it pushes the brain downward causing brain herniation, unconsciousness |
| Symptoms of subdural haematoma | 10 contralateral hemiparalysis, isalateral pupil dilation, changes in levels of consciousness |
| what is an extradural haematoma? | a bleed between skull and dura |
| how to treat extradural haematoma? | drill burr holes into skull |
| What are the 2 types of skull fracture? | 1) linear fracture 2) depressed skull fracture |
| What can a skull fracture give rise to? | infection, CSF leaks and bleeding |
| What causes posttraumatic epilepsy? | the pressence of scar tissue, specifically alterations in neurological membrane function and its structure |
| What is the intial management of hea dinjuries? | ABC |
| what is retrograde amnesia? | loss of memory preceding injury |
| What is antrograde amnesia? | loss of memory for events after trauma |
Created by:
Jem S
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