Neurotrauma and Spinal Cord Injury

Flashcards covering the pathophysiology, categories, and specific clinical manifestations of traumatic brain and spinal cord injuries based on lecture notes.

The two main categories of traumatic head injury are __________ trauma and penetrating (open, missile) trauma.

blunt (closed, non-missile)

__________ injury is caused by the impact itself and involves neural and primary glial injury as well as a vascular response.

Primary

Secondary injury includes cerebral edema, brain swelling, hemorrhage, infection, and increased __________.

$$\text{ICP}$$

A __________ injury is a specific, grossly observable brain lesion such as a hematoma or cortical contusion.

focal

Cerebral contusions are most common in the __________ and temporal lobes.

frontal

A __________ contusion occurs on the side of the brain where the impact occurred.

coup

A __________ contusion occurs on the opposite side of the brain to the point of impact.

contrecoup

Epidural hematoma is most common in individuals aged $20-40$ years and is associated with arterial bleeds in __________% of cases.

$$85\%$$

Epidural hematomas are typically associated with a temporal bone fracture and the shearing of the __________ artery.

middle meningeal

The clinical presentation of an epidural hematoma often includes an initial __________, followed by a later decrease in LOC.

lucid interval

Subdural hematomas are usually caused by the tearing of __________ or the dural sinus.

bridging veins

A __________ subdural hematoma develops over a period of weeks to months and is common in the elderly and alcohol abusers.

chronic

Subarachnoid hemorrhage involves bleeding between the __________ and pia mater.

arachnoid

According to Cantu Guidelines (2001), a Grade 3 (Severe) concussion involves a loss of consciousness for more than __________ minutes.

$$5$$

Diffuse Axonal Injury (DAI) results from rotational acceleration and shearing stresses that cause torn axons to regress into __________ visible under a microscope.

retraction balls

In __________ DAI, which is present in $16\%$ of all severe head injuries, the patient remains deeply unconscious with a poor prognosis.

Severe

The most common cause of spinal cord trauma, accounting for $55\%$ of cases, is __________.

MVCS

Spinal cord injuries at levels __________ to __________ result in paralysis of respiratory muscles and are usually fatal.

C1; C4

Within $24$ hours of a spinal cord injury, necrosis consumes __________% of the cross section of the cord.

$$70\%$$

The period of __________ follows the onset of injury and is characterized by a $24-72$ hour period of paralysis, hypotonia, and areflexia.

spinal shock

The return of the __________ reflex indicates the end of spinal shock.

bulbocavernosus

__________ is a life-threatening, massive, uncompensated cardiovascular response to SNS stimulation that can occur after spinal shock ends.

Autonomic hyperreflexia

One manifestation of autonomic hyperreflexia is a systolic blood pressure that can reach up to __________ mm Hg.

$$300$$