Trauma and Head Injuries Quiz
66 Questions
4 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What percentage of deaths from major trauma are attributed to head injuries?

  • 70%
  • 25%
  • 50% (correct)
  • 30%

    • What is the leading cause of death for individuals under the age of 45?

  • Trauma (correct)
  • Cancer
  • Heart disease
  • Stroke

    • What is the approximate annual number of deaths due to head injuries in the Republic of Ireland?

  • 700
  • 600
  • 450 (correct)
  • 200

    • What is the morbidity rate for inpatient adults suffering from head injuries?

    <p>50%</p> Signup and view all the answers

    What percentage of patients with severe polytrauma experience traumatic brain injury (TBI)?

    <p>70%</p> Signup and view all the answers

    What is one of the key components of medical management for patients with impaired consciousness?

    <p>30° head up position</p> Signup and view all the answers

    Which medication is specifically utilized for managing intracranial pressure?

    <p>Mannitol</p> Signup and view all the answers

    What is a recognized long-term sequela of traumatic brain injury?

    <p>Post-concussion syndrome</p> Signup and view all the answers

    Which of the following is NOT part of anesthetic management in patients with impaired consciousness?

    <p>Intravenous fluids</p> Signup and view all the answers

    What surgical procedure may be performed to remove causative pathology in a patient with elevated intracranial pressure?

    <p>Decompressive craniectomy</p> Signup and view all the answers

    Which pediatric brain tumor is the most common and typically benign?

    <p>Astrocytoma</p> Signup and view all the answers

    What is the primary source of brain metastases in adults?

    <p>Lung cancer</p> Signup and view all the answers

    Which type of pediatric tumor is characterized by its ability to seed along CSF pathways?

    <p>Medulloblastoma</p> Signup and view all the answers

    What characteristic is true about diffuse brain stem tumors?

    <p>They have a very poor prognosis.</p> Signup and view all the answers

    In pediatric gliomas, which type has a higher prevalence?

    <p>Astrocytoma</p> Signup and view all the answers

    What is the most common cause of death in the age group 1-15?

    <p>Severe head injury</p> Signup and view all the answers

    What is a common characteristic of acute subdural hematoma?

    <p>It is typically crescent-shaped.</p> Signup and view all the answers

    Which type of brain tumor is most common in adults?

    <p>Astrocytic tumors</p> Signup and view all the answers

    What type of brain injury accounts for 35% of all fatal head injuries?

    <p>Diffuse axonal injury</p> Signup and view all the answers

    What is the preferred imaging technique for diagnosing brain tumors?

    <p>MRI</p> Signup and view all the answers

    What is the primary goal of management in traumatic brain injury?

    <p>Prevent secondary brain injury</p> Signup and view all the answers

    What characterizes glioblastoma pathology?

    <p>Nuclear pleomorphism</p> Signup and view all the answers

    What is the lucidity described in the context of extradural hematoma?

    <p>Clear consciousness for a period following injury</p> Signup and view all the answers

    Which treatment option is typically associated with meningiomas?

    <p>Maximal safe resection</p> Signup and view all the answers

    Which group is most at risk for chronic subdural hematoma?

    <p>Elderly individuals on anticoagulants</p> Signup and view all the answers

    For which type of tumor is the STUPP protocol relevant?

    <p>Glioblastoma</p> Signup and view all the answers

    What is the initial assessment protocol for traumatic brain injury?

    <p>ABC assessment</p> Signup and view all the answers

    Which of the following is true regarding penetrating cranial injuries?

    <p>Infection is a common complication.</p> Signup and view all the answers

    What is a common clinical presentation of increased intracranial pressure?

    <p>Seizures</p> Signup and view all the answers

    What is a key treatment option for non-functioning pituitary adenomas?

    <p>Surgical intervention</p> Signup and view all the answers

    What can raised intracranial pressure lead to?

    <p>Reduced oxygen supply to brain</p> Signup and view all the answers

    Which symptom is associated with diffuse axonal injury?

    <p>Prolonged unconsciousness</p> Signup and view all the answers

    What type of brain tumor arises from Schwann cells?

    <p>Vestibular schwannoma</p> Signup and view all the answers

    What percentage of patients with severe polytrauma are affected by traumatic brain injury (TBI)?

    <p>70%</p> Signup and view all the answers

    Which of the following statistics reflects the mortality rate associated with head injuries in the Republic of Ireland?

    <p>10 per 100,000 per year</p> Signup and view all the answers

    What proportion of inpatient adults experience morbidity as a result of head injuries?

    <p>50%</p> Signup and view all the answers

    How many people per year in the UK attend Emergency Departments due to head injuries?

    <p>449,000</p> Signup and view all the answers

    Among major trauma deaths, what is the percentage attributed specifically to head injuries?

    <p>50%</p> Signup and view all the answers

    Which pediatric brain tumor is characterized by its high malignancy and ability to spread along CSF pathways?

    <p>Medulloblastoma</p> Signup and view all the answers

    What is the most common type of brain tumor in childhood?

    <p>Astrocytoma</p> Signup and view all the answers

    Which of the following sources accounts for over 40% of brain metastases in adults?

    <p>Lung cancer</p> Signup and view all the answers

    Which tumor type arises from the lining of the ventricles or central canal of the spinal cord and is most common in children and young adults?

    <p>Ependymoma</p> Signup and view all the answers

    What is the prognosis of diffuse brain stem tumors, which infiltrate all layers of the brain stem?

    <p>Very poor, with low survival rates</p> Signup and view all the answers

    What is the purpose of hyperventilation in the anesthetic management of patients with impaired consciousness?

    <p>To achieve cerebral vasoconstriction</p> Signup and view all the answers

    Which of the following statements about post-traumatic epilepsy is incorrect?

    <p>Prophylactic AEDs show benefit beyond one week</p> Signup and view all the answers

    What is a crucial factor in deciding surgical intervention for intracranial pressure management?

    <p>Presence of a clot or tumor</p> Signup and view all the answers

    Which management technique is not typically employed in the long-term management of patients with traumatic brain injuries?

    <p>Prophylactic administration of anticoagulants</p> Signup and view all the answers

    Which surgical procedure is intended for the evacuation of hematomas in cases of elevated intracranial pressure?

    <p>Decompressive craniectomy</p> Signup and view all the answers

    What is the typical first line of treatment for meningiomas?

    <p>Maximal safe resection</p> Signup and view all the answers

    Which of the following statements accurately describes glioblastoma?

    <p>Nuclear pleomorphism is a pathological feature.</p> Signup and view all the answers

    What is the main role of postoperative imaging in the treatment of high-grade astrocytomas?

    <p>To assess the extent of resection.</p> Signup and view all the answers

    Which type of brain tumor is most commonly associated with neurofibromatosis type 2 (NF2)?

    <p>Vestibular schwannomas</p> Signup and view all the answers

    For which condition is the STUPP protocol primarily indicated?

    <p>Glioblastoma</p> Signup and view all the answers

    Which of the following is NOT a common clinical presentation of brain tumors?

    <p>Shortness of breath</p> Signup and view all the answers

    Which treatment option is often used for recurring or residual meningiomas?

    <p>Radiation and/or focused radiation</p> Signup and view all the answers

    What is a hallmark feature of chronic subdural hematoma?

    <p>History of minor trauma is often present</p> Signup and view all the answers

    Which primary brain tumor has the highest incidence rate among adults?

    <p>Astrocytic tumor</p> Signup and view all the answers

    Which statement is true about the management of diffuse axonal injury (DAI)?

    <p>Conservative management is the primary approach</p> Signup and view all the answers

    What risk factor is NOT associated with chronic subdural hematoma?

    <p>History of significant head trauma</p> Signup and view all the answers

    What characterizes the presentation of an extradural hematoma?

    <p>It may present with a lucid interval after the injury</p> Signup and view all the answers

    What type of brain injury is predominantly caused by blunt trauma and often involves a linear skull fracture?

    <p>Extradural hematoma</p> Signup and view all the answers

    Which complication can arise from increased intracranial pressure (ICP)?

    <p>Herniation syndromes</p> Signup and view all the answers

    What is a key characteristic of intracerebral hematoma?

    <p>Associated frequently with vascular injury</p> Signup and view all the answers

    What defines focal brain injury?

    <p>Results in specific, localized areas of damage</p> Signup and view all the answers

    What is the typical mortality rate associated with acute subdural hematoma?

    <p>30-90%</p> Signup and view all the answers

    Which factor contributes to preventing secondary brain injury in traumatic brain injury management?

    <p>Maintaining adequate cerebral perfusion</p> Signup and view all the answers

    Study Notes

    Head Injuries & Cerebral Neoplasm

    • Learning Objectives: Describe types of head injuries, understand intracranial pressure, recognize brain hemorrhages, assess brain injured patients (including GCS), describe medical/surgical management options, and discuss brain tumors.
    • Head Injury Statistics: 449,000 UK Emergency Department attendances per year. Trauma is the leading cause of death under 45, with head injuries accounting for up to 50% of these deaths. 70% of patients with severe polytrauma have TBI. High morbidity & mortality - 50% of inpatient adults have morbidity from HI.
    • Head Injury Epidemiology: Falls account for 28% of cases. Motor vehicle traffic is 20%. Struck by/against incidents are 19%. Assault accounts for 11% of incidents. Pedal cycle incidents comprise 3%. Other transportation 2%. Suicide 1%. Unknown 9%. Other incidents 7%.

    Primary Brain Injury

    • Damage at Time of Injury: The presentation describes different types of primary brain injury, including types of blood loss, scalp laceration, foreign body, linear fractures, and depressed fractures in relation to injury location. It also details intracranial hemorrhage (intra-cerebral hemorrhage, acute subdural hematoma, chronic subdural hematoma, epidural hematoma) and diffuse axonal injury.

    Scalp, Skull & Perforating Cranial Injuries

    • These sections detail the location, type, and characteristics of injury to the scalp, skull, and perforating cranial injuries, often visually illustrated with CT scans or medical images. Illustrations aid the understanding of the location of injury.

    Focal Brain Injuries

    • This section presents images and discussion about focal brain injuries, typically evidenced by CT scan findings indicative of injury location and extent.

    Monro-Kellie Doctrine & Raised ICP

    • The Monro-Kellie doctrine explains the relationship between intracranial pressure and the three components (blood, brain tissue, cerebrospinal fluid). Images and descriptions aid understanding.
    • Consequences of Raised ICP: Herniation syndromes, reduced cerebral perfusion are presented as results of raised ICP.

    Secondary Brain Injury

    • Systemic: Hypoxia, hypotension, hypercapnia, hyperthermia, and poor glycemic control are presented as systemic contributors to secondary brain injury.
    • Intracranial: Brain swelling, brain shift & herniation, raised ICP, post-traumatic seizure, and intracranial infection as intracranial contributors associated with secondary brain injury.

    Specific Hematoma Types

    • Extradural Hematoma: Typically associated with blunt trauma, often temporal location, middle meningeal artery tear, lucid interval, and emergency craniotomy treatment.
    • Acute Subdural Hematoma: Venous tear/brain laceration, covers the entire cerebral surface, crescent shape, associated parenchymal injury, morbidity/mortality from underlying brain injury, 30-90% mortality rate, and emergency craniotomy treatment.
    • Chronic Subdural Hematoma: History of minor trauma, risk factors such as age, gender, anticoagulants, coagulopathy, thrombocytopenia, or alcoholism, early burr hole drainage treatment for raised ICP or lateralizing signs.
    • Intracerebral Hematoma: 15% of fatal head injuries with associated contusions, diffuse axonal injury, subdural hematoma, usually conservative treatment but evacuation for raised ICP or marked midline shift.

    Diffuse Axonal Injury (DAI)

    • Account for 35% of fatal head injuries, presenting usually with prolonged unconsciousness without obvious mass lesion, petechial hemorrhage, effaced basal cisterns, compressed ventricles, loss of grey/white differentiation, and conservative or decompression craniectomy management.

    Penetrating Injuries

    • These are frequently associated with vascular injuries, infections, and are universally fatal if crossing the midline. Wound debridement, removal of foreign bodies, and angiography are common management approaches.
    • Assessment: ABC assessment (Airway, Breathing, Circulation) which considers associated c-spine injuries (5-10% of cases), early anesthetic involvement, and rapid transfer to a neurosurgical unit (NSU).

    Glasgow Coma Scale

    • Presents the evaluation tool with criteria for eye, verbal, and motor responses (with scores).

    Medical Management

    • Head position elevated 30 degrees, Mannitol, anti-epileptics, hypertonic saline, and ICP monitoring are included in medical approach.

    Anesthetic Management

    • Treatments including paralysis, sedation, analgesia, hyperventilation (lower CO2), and hypothermia are commonly used in the anesthetic management of patients.

    Surgical Management

    • Intercranial pressure monitoring during surgical treatment is detailed. Includes evacuation of hematoma via craniotomy—visual examples of this procedure are presented throughout the notes.

    Craniotomy - Hematoma Evacuation

    • Procedures for the removal of hematoma via craniotomy are visually illustrated.

    Long-Term Sequelae

    • Examples provided of potential long-term effects: post-traumatic epilepsy, and post-concussion syndrome (behavioural change, headache, dizziness, mood swings, irritability, memory loss) are included.

    Brain Tumors:

    • Learning Objectives: classification, pathogenesis, treatment (surgical vs nonsurgical), basic cerebral anatomy, intracranial and extracranial locations, and clinical presentation
    • Clinical Presentation: Progressive neurological deficit, symptoms of raised ICP (early morning headaches, vomiting), seizures, hydrocephalus, hemorrhages, endocrine disturbance, and asymptomatic presentations are included in the discussion of clinical presentation of brain tumors.

    Brain Tumors (Types & Characteristics)

    • The presentation provides an overview of common adult primary brain tumors from different origins, including glial tumors (Astrocytic, Oligodendroglial, Mixed), Meningioma, Pituitary/Pineal/Nerve Sheath, and diverse rarer tumors.
    • GlioBlastoma: Peak age 45-60, 50% of astrocytomas, 20% of primary brain tumors. The presentation describes the histology (nuclear pleomorphism, high mitotic count, necrosis). Treatment includes maximal safe resection, histopathological diagnoses, postoperative scans, and postoperative radiotherapy (STUPP protocol).
    • Low-Grade Astrocytoma: 15% of astrocytomas, peak age 30, transformation to higher grades described. Gross resection and radiotherapy are shown to have 70% survival rates.
    • Meningioma: Extra-axial origin, arising from arachnoid cap cells. Primarily a surgical disease, with classification primarily through location and treatment focused on radiation for residual or recurrent tumors. Images support this section.
    • Vesticular Schwannoma: Arising from the vestibular branch of cranial nerve VIII, characterized by progressive hearing loss, and bilateral in neurofibromatosis type 2. Treatment choices including surgery and stereotactic radiosurgery with observation are highlighted.
    • Pituitary Adenomas: Differentiates functioning and non-functioning tumors and describes symptoms, treatment with drugs, surgery, or radiation.
    • Primary CNS Lymphoma: Increased incidence in immunocompromised patients (AIDS, organ transplant). Diagnosis and treatment is through biopsy and chemotherapy.

    Brain Tumors (Sources of Brain Mets in Adults)

    • Lung cancer, breast cancer, renal cell cancer, gastrointestinal cancers, melanoma and undetermined causes are listed as significant sources of brain metastases in adults.

    Pediatric Brain Tumors

    • Gliomas: Second most common childhood brain cancers (19%, excluding leukemia), primarily astrocytomas, medulloblastomas, and ependyomas.
    • Cerebellar Astrocytoma: Most prevalent childhood brain tumor, typically benign, slow-growing, with a 90% cure rate and making up 30% of posterior fossa tumors in children.
    • Medulloblastoma: Arise from the cerebellar vermis, are highly malignant, seed along CSF pathways, and often metastasize to the spinal axis.
    • Ependymoma: Originate from cells lining the ventricles or central canal of the spinal cord. Most common in children and young adults.

    Diffuse Brainstem Tumor

    • Malignant, poor prognosis, brain stem swelling and infiltration of all layers, causes cerebellar dysfunction, cranial nerve palsies, and paresis.

    Operative Considerations

    • This section describes various operative approaches focusing on precise anatomical locations of potential resection areas (orbit, zygoma, petrosal, retrosigmoid, supracerebellar-infratentorial, suboccipital, subtemporal, far lateral).
    • Techniques are illustrated.

    Neuroimaging and Operative Procedures

    • Illustrations with descriptions for awake craniotomy, enhanced imaging, navigation, and various microscopic views support this section.

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Related Documents

    RCSI Head Injuries & Cerebral Neoplasm Year 2 Past Paper PDF

    Description

    Test your knowledge on the prevalence and management of head injuries. This quiz covers key statistics, treatment protocols, and complications associated with traumatic brain injuries. Ideal for medical students and professionals seeking to enhance their understanding of major trauma.

    More Like This

    Use Quizgecko on...
    Browser
    Open
    Browser
    Browser