craniocerebral trauma

Craniocerebral trauma: mechanism, pathophysiology and imaging findings – P. Parizel, Belgium

Different underlying pathology but GCS is 9/15:

Scalp lesions extracranial hematoma, subgaleal, cephalohematoma

Remember to find the coup side of the injury

 Loacations of contusions:

Acute subdural hematomas have the highest mortality rate of all head injuries

If diploic fracture - possibility that EDH is venous - managed w expectancy, example anterior middle fossa, along transverse sinus.

Secondary injuries are important determinants of outcome

Diffuse edema - Tentorium can be pushed backwards

Central herniation - can cause duret hemorhage probably by damaging the pons perforants - 75% mortality

Remember also transcalvarial and occipital decending herniation

MRI used when CT != Clinical findings

DAI injuries are sheering injuries between different substances or organizations.

DWI along with SWI/T2*GRE(TE=35) are the methods of choice for finding these injuries.

Cytotoxic injury mediated by glutamate that is not re-uptaken.

Impaired executive function following mild TBI is associated with axonal injury involving the Dorsolateral prefrontal cortex (DLPFC). Measured with mean diffusivity(MD) and fractional anisotropi(FA).

New methods: Tractography, F-A

Perfusion showing loss of perfusion after loss of regulation

neuro trauma hjärna - harriet nyström ST undervisning i trauma