Block 13 Traum Brain Inj Raised Icp MCQ's
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- 1.Following even minor trauma to the brain (i.e. mild concussion), most patients complain of headache for varying periods ranging from a few minutes to several days and up to a year. Which one of the following mechanisms may help to explain the causation of post-traumatic headache?
- A.
Activation of nociceptors in the bone overlying the point of minor trauma
- B.
Activation of nociceptors in muscles of the scalp and neck
- C.
Activation of the neo-spinothalamic tract reaching consciousness
- D.
Activation of the paleospinothalamic tract reaching consciousness
- E.
High levels of serotonin in blood due to stress related to the trauma
- 2.A 24-year-old man was pushed down a flight of stairs in a fight. He briefly lost consciousness, then regained consciousness and went to dinner. After 1h at the restaurant he lost consciousness again. He was rushed to the emergency room and after airway, breathing and circulation were assessed and secured a CT scan of the head was performed. An eye exam showed a fixed and dilated right pupil. The most likely pathology in this patient is:
- A.
Subdural hematoma
- B.
Epidural hemorrhage/hematoma
- C.
Brain concussion
- D.
Brain stem herniation
- E.
Brain laceration
- 3.A 24 years old man had a motor vehicle accident with a head trauma that resulted in fracture of skull above and anterior to external ear. You expect extradural hemorrhage and increase in intracranial pressure. If that leaded to herniation of uncus of the temporal lobe of the brain, it can cause
- A.
Bilateral upward deviation of the eyeball.
- B.
Deviation of the tongue opposite to the side of lesion.
- C.
Paralysis of the muscles of mastication bilaterally.
- D.
Facial paralysis on the side of lesion.
- E.
Fixed and dilated pupil on the side of lesion.
- 4.If a 40-year-old woman, diagnosed with an acute right subdural hematoma, suddenly develops a right ptosis with a dilated pupil non-reactive to light, the most likely cause is:
- A.
Acute hydrocephalus
- B.
Occipital lobe infarct
- C.
Laceration of ipsilateral pedunculus
- D.
Laceration of contralateral pedunculus
- E.
Transtentorial hypoccampal herniation
- 5.Concerning acute subdural hematomas, choose the correct answer:
- A.
They are caused by traumatic injury only
- B.
They arise from tearing of bridging veins
- C.
They arise from tearing of middle meningeal arteries
- D.
They are most commonly present at the base of the brain
- E.
They are often unilateral
- 6.The earliest manifestations of uncal herniation are associated with:
- A.
Tears of basilar artery with Duret hemorrhage
- B.
Compression of posterior and superior cerebellar arteries and cerebellar infarctions
- C.
Compression of cranial nerve III
- D.
Compression and tears of cerebral peduncles
- 7.Which of the following brain changes are characteristic for diffuse axonal injury?
- A.
Cerebral edema with herniation
- B.
Widespread areas of cortical and subcortical hemorrhages
- C.
Axonal swelling
- D.
Neuronal swelling and dissolution of Nissl substance
- 8.Which of the following conditions are indications for spinal tap?
- A.
Chronic meningitis and increased intracranial pressure
- B.
Increased intracranial pressure due to intracranial mass
- C.
Acute meningitis and subarachnoid hemorrhage due to berry aneurysm rupture
- D.
Acute meningitis and intracerebral hemorrhages due to hemophilia A
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