Crescent shape on CT is what type of injury?
Subdural hematoma
Subdural Hematoma results from tearing of what?
(U) VeinsArteries are possible as well
Subdural Hematoma results in separation of what?
Arachnoid from dura
Subdural Hematoma prognosis?
Poor
Elliptical shape on CT is what type of injury?
Epidural hematoma
Epidural hematoma results from tearing of what?
Arteries
Epidural hematoma is bleeding into what space?
b/w dura and skull
Epidural hematoma prognosis depends on what?
Mass effect, pushing against brain as the dura pulls away from skull
Injury to temporal or occipital region most commonly results in what kind of bleed?
Epidural hematoma
Slivers on CT is what type of injury?
Subarachnoid hematoma
Blood in CSF is indicative of what injury?
Subarachnoid hematoma
Concussion is?
Trauma-caused alteration in mental status, with or without LOC
Concussions mechanism of injury in the brain?
Shearing of axons
Seizure is?
Hyperdischarge of brain neurons causing involuntary behavior, motor, sensation
Epilepsy is?
2+ unprovoked seizures
Seizures can be provoked by?
Fever Head trauma Illness Metabolic imbalance Ingested toxin
Seizure classes?
Generalized: tonic-clonic affecting entire body
Focal: from specific area of cortex, +/- spread to entire brain
Seizure DDX?
Syncope (can have tonic-clonic)
Breath-holding
Tourette syndrome
Seizure tx: Tonic-Clonic Absence Partial Neonate Acute treatment
Valproic Acid (Depakote) Ethosuximide Carbamazepine Phenobarbital BZs
Bacterial Meningitis mechanism?
Replication in subarachnoid space
Bacterial Meningitis seen mostly in what population?
<6mo due to MMR, Hib and pneumo vaccines at 6mo
Bacterial Meningitis most C cause <2mo?
E coli or Klebsiella
Bacterial Meningitis most C cause 2-6mo?
S pneumo
Bacterial Meningitis most C cause 6mo-1yr?
Neisseria
then S pneumo
Bacterial Meningitis general presentation?
1) Insidious onset of fever and nonspecific sxs
2) Rapid (1-2hr) onset of fever and mental status changes
Bacterial Meningitis specific signs?
FEVER Neck pain/rigidity HA/Photophobia Mental status changes (P) Focal neuro deficits
Bacterial Meningitis dx?
Lumbar puncture U = Leukocytosis Low Glucose High protein \+ culture
Bacterial Meningitis tx: 2mo?
Ampicillin + Cefotax + aminogly
Dexamethasone + Cefotax
Bacterial Meningitis specialized PE tests?
Kernig’s: straightened leg = back pain and neck flex
Brudzinski’s: passive neck flex = involuntary leg bending
Bacterial Meningitis sequela?
Deafness
Congnitive deficits
Viral (Aseptic) Meningitis most C cause?
Enterovirus
Viral Meningitis epidemiology?
U < 1 yo
Summer/Winter
Viral Meningitis presentation?
U fever, ST –»
Severe HA
Viral Meningitis dx?
Lumbar puncture = Leukopenia Neutrocytosis early Lymphocytosis later Glu and Protein N
Cerebral Palsy is?
Timing?
Brain damage affecting mm movement
Before, during or after birth up to 3 yo
Cerebral Palsy presentation?
Stiff or floppy
Asymmetric tone/movements
Miss milestones
Cerebral Palsy Spastic Type?
Most C
Pyramidal tract lesions
Hypertone/stiffness
Hyperreflex, clonus
Cerebral Palsy Dyskinetic Type?
Extrapyramidal
Involuntary mvmt
Cerebral Palsy Ataxic Type?
Tremors
Lost coordination
Cerebral Palsy DDX?
Degenerative dis
Metabolic dis
Neuromuscular dis
CA of brain or cord