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DPT_NEURO_10
TRAUMATIC BRAIN INJURY
| Question | Answer |
|---|---|
| Sign of CSF leak in skull fracture | Otorrhea & rhinorrhea |
| What to assess for if there is fluid in nose/ears after skull fracture and suspecting CSF leakage | Halo sign and glucose |
| C/I to assess for glucose in CSF leakage | If bloody |
| Jarring of the brain | Concussion |
| Concussion is mainly d/t | Acceleration / deceleration of head |
| Is the neurologic dysfnx in Concussion temporary or permanent | Temporary |
| Bruising of the brain | Contussion |
| Common part of brain affected by contussion | Frontal / temporal |
| Structural differences b/n contussion & concussion | Contussion has structural damage while concussion has none |
| S/sx of contussion | Decreased LOC, confusion, edema |
| edema in contussion peaks at | 18-36 hrs |
| Shearing or rotational forceps r/t MVA | Diffuse axonal injury |
| S/sx of DAI | Immediate comatose and no lucid interval |
| It is the bleeding b/n skull and dura mater | Epidural hematoma |
| What is the cause of Epidural hematoma | Rupture of middle meningeal artery |
| Classic sign of Epidural hematoma | Brief LOC -> lucid interval -> comatose |
| Surgical interventions for Epidural hematoma | Burrhole / craniotomy |
| Diagnostic test in Epidural hematoma | CT scan |
| Findings in CT scan for Epidural hematoma | Convex lens shape, well defined |
| Does Epidural hematoma cross suture line | NO |
| What causes subdural hematoma | Rupture in bridging veins b/n DM & AM |
| Type of subdural hematoma where there is rapid decrease in LOC and increase in ICP and hemiparesis | Acute |
| Type of subdural hematoma where it is common for elderly and alcoholic | Chronic |
| Type of subdural hematoma where there is slow onset of personality changes and confusion | Chronic |
| Diagnostic test for subdural hematoma | CT scan |
| CT scan results of subdural hematoma | Concave shaped |
| Does subdural hematoma cross suture line | Yes |
| Main cause of subarachnoid hematoma | Rupture of berry aneurysm |
| Triad sign of subarachnoid hematoma | HA, N/V, Meningeal signs |
| Characteristic of HA in subarachnoid hematoma | "worst headache of my life" Sudden onset (thunderclap) |
| Drug for subarachnoid hematoma | Antihypertensive |
| Surgical mgt for subarachnoid hematoma | Surgical clipping / coiling |
| Best initial test of all in TBI | Plain cranial CT scan |
| Patient has thunderclap headache but CT scan came back negative, what is next | Suspected SAH, proceed to lumbar puncture |
| Lumbar puncture hallmark diagnostic finding for a subarachnoid hemorrhage | Xanthrochromia - yellowish appearance of CSF |
| Position for TBI | HOB 15-30 Neck in neutral position |
| 2 surgical procedures for TBI | Supratentorial / Infratentorial surgery |
| Position after Supratentorial surgery | HOB 15-30, head midline / neutral |
| Position after Infratentorial surgery | Flat in bed / side lying |
Created by:
ah_jusyyy