Traumatic Brain Injury, Acceleration-Deceleration Dynamics, and Subdural Hematoma

A set of 20 vocabulary flashcards covering the biomechanics, pathophysiology, clinical presentation, and management of traumatic brain injury and subdural hematomas.

Traumatic Brain Injuries (TBIs)

Injuries that frequently stem from rapid acceleration-deceleration forces.

Coup injury

The primary focal contusion sustained at the direct anatomical site where the skull strikes an external object.

Contrecoup injury

Secondary injury occurring when the mobile brain accelerates backward within the cranial cavity as the moving skull halts, impacting the opposite inner skull wall.

Subdural Hematoma (SDH)

Extravasation of blood within the subdural space, situated between the dura mater and the arachnoid layer.

Subdural space

The anatomical compartment situated between the dura mater and the arachnoid layer where blood collects during a subdural hematoma.

Bridging cortical veins

Low-pressure vessels whose tearing serves as the vascular origin of a subdural hematoma.

Velocity of bleeding in SDH

A slow progression stemming from a venous source, allowing blood to accumulate insidiously over days to weeks.

Age-related cerebral atrophy

Brain shrinkage that stretches bridging veins across a wider subdural space, increasing susceptibility to tearing even from minor trauma.

Pharmacological anticoagulation

Medication therapy (such as apixaban / Eliquis, warfarin) that impairs hemostasis in trauma patients.

Initial head CT in delayed hemorrhage

An emergency department non-contrast head CT that can initially present as completely negative for acute intracranial hemorrhage.

Insidious decompensation

Progressive development of subtle mental status changes over subsequent days, including increased lethargy, anorexia, irritability, and somnolence.

Midline brain shift

A profound displacement of brain tissue visible on re-evaluation, caused by an extensive, space-occupying subdural hematoma.

Clinical signs of advanced brain shift

Progressive neurological manifestations including snoring respirations, low GCS, pupillary asymmetry, and motor posturing.

Surveillance non-contrast head CT protocol

A repeat scan indicated 6 to 12 hours after an initial negative scan for anticoagulated head trauma clients to identify delayed, occult venous hemorrhage before severe brain shifts occur.

Rapid pharmacological anticoagulation reversal

Administration of targeted antidotes, such as Vitamin K alongside 4-Factor PCC / Kcentra, to rapidly reverse prolonged coagulation times prior to intervention.

4-Factor Prothrombin Complex Concentrate (4-Factor PCC / Kcentra)

A targeted antidote administered alongside Vitamin K for rapid reversal of prolonged coagulation times prior to intervention.

Mannitol

An osmotic diuretic administered to suppress acute intracranial pressure (ICP) spikes.

IV antiepileptic agents

Intravenous medications administered in the acute management of subdural hematomas to suppress seizures.

Burr holes

An urgent neurosurgical technique used to evacuate blood and relieve physical tissue shifting.

Formal craniotomy

An urgent neurosurgical operative procedure performed to evacuate a space-occupying hematoma and relieve physical tissue shifting.