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The goal of mankind is knowledge, which is is inherent in man. No knowledge comes from outside: it is all inside. What man 'learns' is really what he “ discovers ” by taking the cover off his own soul.   Swami Vivekananda   “ Education” - Eduse (latin) to bring out..
CPC07-4.3.5-CNS-Head Injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Examination: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Control your senses and you are beyond trouble,   Let them loose and you are beyond help…! Lao Tzu
Pathology of  Head Injury Dr. Shashidhar V.M. Senior Lecturer & Head of pathology
Head Injury Background ,[object Object],[object Object],[object Object],[object Object]
Head Trauma: Brain injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Brain Injury Morphologic Types:  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Missile Injury: Types ,[object Object],[object Object],[object Object]
Missile Injury: The “blast effect” of a high-velocity projectile causes an immediate increase in supratentorial pressure and results in death because of impaction of the cerebellum and medulla into the foramen magnum.  A low-velocity projectile increases the pressure at a more gradual rate through hemorrhage and edema.
Non-missile / Blunt Head Injury:   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Coup  Contre Coup
Whiplash injury:
Pathogenesis of Injury: ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Axonal Injury: A,  Hypoxic/ischemic injury in cerebral cortex - "red neurons." shrunken cell B,  Axonal spheroids at points of axonal disruption  C,  Swollen cell body and peripheral dispersion of Nissl substance (chromatolysis) H&E Stain.
Cerebral Edema: Normal Edema
Mechanisms of diffuse injury:  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cerebral Edema: narrow sulci, flat gyri.
Head Injury: ,[object Object]
Head Injury: ,[object Object]
The greatest religion is to be true to your own nature.   Swami Vivekananda
Intracranial hematoma: Pathological Mechanisms & clinical manifestations No special features Increased intracranial pressure with focal deficits; usually fatal Profound coma , usually rapidly fatal Cortical contusions Rupture of small intrinsic vessels with intracerebral haematoma 'Burst lobe' with intracerebral haematoma contusions and subdural haematoma Cerebral hemisphere Meningeal irritation  with a rapid increase in intracranial pressure Arterial  rupture Subarachnoid space Acute presentation  with a rapid increase in intracranial pressure Chronic presentation with personality change, memory loss and confusion, particularly in the elderly Rupture of  venous  sinuses or small bridging veins due to torsion forces Subdural space Lucid interval  followed by a rapid increase in intracranial pressure Skull fracture  with  arterial  rupture, e.g. middle meningeal artery Epidural /Extradural Clinical manifestations Mechanism Site
Epidural Hematoma Fracture
Epidural  -  Hematoma  -  Subdural
Epidural Hematoma ,[object Object]
Epidural hematoma -Skull Fracture.
Epidural Hemorrhage Dura Adherent clot
Subdural Hematoma: With head trauma, the dura moves with the skull, and the arachnoid moves with the cerebrum, . As a result, the bridging veins are sheared causing hematoma in the expansile subdural space.
Subdural Hematoma ,[object Object]
Subdural Hematoma
Subdural Hemorrhage Dura Arachnoid Shift Bleeds
Subdural Hematoma:  edema & Herniation Flattening Subfalcine Herniation Uncal Herniation
Head Injury:Healing ,[object Object],[object Object]
Head Injury:Healing ,[object Object],[object Object]
You cannot shake hands with a clenched fist. -Indira Gandhi
You may get  delayed  to reach your targets. But every step you take towards your target is step towards  victory . KARL MARX
45y F, Head injury following car accident.Image shows gross specimen brain.  ? Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
45y F, Head injury following head on collision, without seat belt.Arrow shows   what type of injury? ,[object Object],[object Object],[object Object],[object Object],[object Object]
45y F, Head injury following car accident. Image shows MRI Scan.?  Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
45y F, Head injury following car accident. Image shows CT Scan.?  Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object]
38y Head injury following vehicle accident. Brain gross   -  What feature is shown by arrow? ,[object Object],[object Object],[object Object],[object Object],[object Object]
38y male driver. Died in car crash. Coroners autopsy Image shows Brain gross  -   What feature is shown by arrow? ,[object Object],[object Object],[object Object],[object Object],[object Object]
45y F, Head injury following car accident.Image shows his Brain  ? Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],2 3 4
Do not let  what you ‘cannot’ do interfere with  what you ‘can’ do . — John Wooden
Sample SAQ: ,[object Object],[object Object],[object Object],[object Object],[object Object]
Head Injury: Clinical severity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Decisions on Head Injuries ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Post-Concussive Syndrome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Second Impact Syndrome ,[object Object],[object Object],[object Object]
Athlete Return to Activity ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Religion is the symptom of craving to know Divinity already inside man.   Swami Vivekananda
You may get  DELAYED  to reach your targets. But every step you take towards your target is  EQUAL  to victory. KARL MARX

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Pathology of Head Injury

  • 1. The goal of mankind is knowledge, which is is inherent in man. No knowledge comes from outside: it is all inside. What man 'learns' is really what he “ discovers ” by taking the cover off his own soul. Swami Vivekananda “ Education” - Eduse (latin) to bring out..
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  • 4. Control your senses and you are beyond trouble, Let them loose and you are beyond help…! Lao Tzu
  • 5. Pathology of Head Injury Dr. Shashidhar V.M. Senior Lecturer & Head of pathology
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  • 10. Missile Injury: The “blast effect” of a high-velocity projectile causes an immediate increase in supratentorial pressure and results in death because of impaction of the cerebellum and medulla into the foramen magnum. A low-velocity projectile increases the pressure at a more gradual rate through hemorrhage and edema.
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  • 14. Axonal Injury: A, Hypoxic/ischemic injury in cerebral cortex - "red neurons." shrunken cell B, Axonal spheroids at points of axonal disruption C, Swollen cell body and peripheral dispersion of Nissl substance (chromatolysis) H&E Stain.
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  • 17. Cerebral Edema: narrow sulci, flat gyri.
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  • 20. The greatest religion is to be true to your own nature. Swami Vivekananda
  • 21. Intracranial hematoma: Pathological Mechanisms & clinical manifestations No special features Increased intracranial pressure with focal deficits; usually fatal Profound coma , usually rapidly fatal Cortical contusions Rupture of small intrinsic vessels with intracerebral haematoma 'Burst lobe' with intracerebral haematoma contusions and subdural haematoma Cerebral hemisphere Meningeal irritation with a rapid increase in intracranial pressure Arterial rupture Subarachnoid space Acute presentation with a rapid increase in intracranial pressure Chronic presentation with personality change, memory loss and confusion, particularly in the elderly Rupture of venous sinuses or small bridging veins due to torsion forces Subdural space Lucid interval followed by a rapid increase in intracranial pressure Skull fracture with arterial rupture, e.g. middle meningeal artery Epidural /Extradural Clinical manifestations Mechanism Site
  • 23. Epidural - Hematoma - Subdural
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  • 26. Epidural Hemorrhage Dura Adherent clot
  • 27. Subdural Hematoma: With head trauma, the dura moves with the skull, and the arachnoid moves with the cerebrum, . As a result, the bridging veins are sheared causing hematoma in the expansile subdural space.
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  • 30. Subdural Hemorrhage Dura Arachnoid Shift Bleeds
  • 31. Subdural Hematoma: edema & Herniation Flattening Subfalcine Herniation Uncal Herniation
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  • 34. You cannot shake hands with a clenched fist. -Indira Gandhi
  • 35. You may get delayed to reach your targets. But every step you take towards your target is step towards victory . KARL MARX
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  • 43. Do not let what you ‘cannot’ do interfere with what you ‘can’ do . — John Wooden
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  • 50. Religion is the symptom of craving to know Divinity already inside man. Swami Vivekananda
  • 51. You may get DELAYED to reach your targets. But every step you take towards your target is EQUAL to victory. KARL MARX