Neurotrauma & Increased Intracranial Pressure Flashcards

Vocabulary practice flashcards covering neurotrauma, skull fractures, traumatic brain injuries, intracranial hemorrhages, and spinal cord syndromes based on the lecture material.

Linear Skull Fractures

Non-displaced fractures of the skull that are generally not problematic unless they occur in an area, such as the temporal bone, where underlying vessels can be lacerated.

Depressed Skull Fractures

Skull fractures involving the downward depression of bone into brain tissue, often resulting from a severe blow to the head with a blunt object.

Comminuted Skull Fractures

Fractures that cause fragmentation and downward displacement of bone into brain tissue.

Basilar Skull Fracture

Fractures occurring at the base of the skull, usually on the temporal or frontal areas, which are often open head injuries and present with headache, altered level of consciousness, Battle's Sign, Raccoon's eyes, and CSF drainage.

Battle's Sign

Unilateral ecchymosis or bruising over the mastoid area behind the auricle of the ear that can occur immediately or days after a basilar skull fracture.

Raccoon (Eyes) Sign

Bilateral periorbital ecchymosis or bruising, especially in the absence of direct orbital trauma.

Traumatic Brain Injury (TBI)

Injury occurring when a sudden trauma causes some level of injury to the brain, caused by direct injury to brain tissue or external forces transmitted to the brain, classified as primary or secondary.

Primary Injuries

Injuries that directly damage tissues and blood vessels resulting from what has occurred to the brain at the time of injury, including skull fracture, contusions/bruises, hematomas/blood clots, lacerations, and nerve damage.

Secondary Injuries

Injuries involving a cascade of physiologic and biochemical events that damage neurons not initially injured in the traumatic event, caused by intracranial and extracranial conditions, and largely preventable and treatable.

Cerebral Concussion

A head injury with temporary loss of neurological function with no structural damage, resulting from jarring of the brain that temporarily disrupts synaptic activity, often caused by acceleration-deceleration injuries.

Diffuse Axonal Injury (DAI)

Widespread brain injury caused by direct damage to axons or disruption of axonal processes, resulting in microscopic hemorrhages throughout the brain tissue that are not usually visible on diagnostic testing.

Moderate DAI

A diffuse axonal injury characterized by minute brain bruising in addition to shearing of brain fibers, accounting for $20\%$ of all severe head injuries and $45\%$ of all DAI cases.

Severe DAI

Disruption of multiple axons in both hemispheres with extension into the brainstem, characterized by a $\text{GCS} < 8$ for more than $6\,\text{hours}$, increased ICP from edema, and rare full recovery.

Subdural Hematoma

The most common traumatic mass-effect lesion, accounting for $20\% - 40\%$ of severe head injuries, resulting from bleeding into the potential space between the dura mater and arachnoid mater due to rupture of bridging veins.

Acute Subdural Hematoma

A subdural hematoma occurring less than $48\,\text{hours}$ after injury, manifesting with altered consciousness, focal motor symptoms opposite the hematoma, same-side pupillary changes, and signs of increased intracranial pressure.

Chronic Subdural Hematoma

A subdural hematoma occurring over $2\,\text{weeks}$ after injury, commonly seen in the elderly, alcoholics, and patients on anticoagulants due to brain atrophy predisposing to tearing of bridging veins.

Epidural Hematoma

Arterial bleeding between the skull and dura mater, with approximately $70\% - 80\%$ caused by meningeal artery injury secondary to temporal or parietal skull fractures.

Subarachnoid Hemorrhage

Bleeding into the subarachnoid space that mixes with cerebrospinal fluid (CSF), classically presenting as 'the worst headache of my life', with $30\%$ being traumatic and $70\%$ non-traumatic secondary to aneurysm rupture.

Cerebral Contusions

Bruising or bleeding on the surface of the brain, most commonly in the frontal, occipital, and temporal lobes, often caused by deformation, rotation, or acceleration-deceleration injuries.

Coup and Contrecoup Injury

Two focal areas of bruising on the brain resulting from acceleration-deceleration or deformation forces, where coup refers to the blow at the impact site and contrecoup refers to the counter-blow on the opposite side.

Central Cord Syndrome

A spinal cord syndrome usually resulting from hyperextension of the neck or C-spine, characterized by upper extremity motor weakness and incontinence.

Anterior Cord Syndrome

A spinal cord injury caused by lack of perfusion to arterioles serving the anterior cord or vertebral artery, causing loss of motor function and loss of sensation to pain, light touch, and temperature, while proprioception and vibration are preserved.

Brown-Séquard Syndrome

A spinal cord syndrome caused by hemitransection from penetrating trauma, resulting in ipsilateral sensory and motor loss and contralateral pain and temperature loss.

Cauda Equina Syndrome

Compression of nerve roots at the lower end of the spinal cord (below $\text{L2}$), presenting with incontinence, weakness in lower extremities, and saddle anesthesia.

Spinal Shock

A temporary state resulting from pressure on the spinal cord, causing flaccidity, anesthesia below the level of lesion, loss of bowel/bladder control, priapism, and hypothermia and hypotension from loss of vascular tone.

Autonomic Dysreflexia

An exaggerated sympathetic response occurring in patients with spinal cord injuries at $\text{T6}$ or higher after resolution of spinal shock, triggered by stimuli such as a full bladder, causing severe hypertension, bradycardia, and flushing/sweating above the lesion.