GUIDE 2022/2023

Over time, cerebral edema will develop leading to loss of gray-white matter distinction.

Describe the injury patterns in high-velocity impact or deceleration injuries on the brain:

Shearing injuries occur at the border between gray and white matter, which present as multiplepunctate hemorrhages throughout the cerebral hemispheres.

This pattern is often characterized as diffuse axonal injury, which has variable often poor outcomes.

Epidural hematomas occur in about % of patients with brain injuries and % of patients with TBI who are comatose.

0.5%, 9%

Describe the appearance of epidural hematomas and how they most often occur:

Biconvex (lenticular, lens-shaped) as they push the adherent dura away from the inner table of the skull.

Most often in the temporal or temporoparietal regions.

Most often result from tears of the middle meningeal artery due to fracture.

Most often arterial in origin, but can result from major venous sinus hemorrhage, or bleeding from askull fracture.

Describe the classic presentation of epidural hematoma:

A lucid interval between the time of injury and neurological deterioration