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Ch. 14 The Brain and Cranial Nerves
Martini - Fundamentals of Anatomy & Physiology 11th Edition
Martini, Nath, Bartholomew11th EditionFundamentals of Anatomy & PhysiologyISBN: 9780136874089Not the one you use?Change textbook
All textbooksMartini, Nath, Bartholomew 11th EditionCh. 14 The Brain and Cranial NervesProblem 30
Chapter 14, Problem 30

Colleen falls down a flight of stairs and bumps her head several times. Soon after, she develops a headache and blurred vision. Diagnostic tests at the hospital reveal an epidural hematoma in the temporoparietal area. The hematoma is pressing against the brainstem. What other signs and symptoms might she experience as a result of the injury?

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Step 1: Understand the anatomy involved. The temporoparietal area is located on the side of the head, and an epidural hematoma here can cause increased intracranial pressure, especially if it presses against the brainstem, which controls vital functions and pathways for motor and sensory signals.
Step 2: Identify the functions of the brainstem. The brainstem regulates autonomic functions such as breathing, heart rate, and consciousness, and contains cranial nerve nuclei that control eye movement, facial sensation, and motor control.
Step 3: Consider symptoms related to brainstem compression. These may include altered consciousness or coma, irregular breathing patterns, abnormal heart rate, difficulty swallowing, weakness or paralysis on one side of the body, and cranial nerve deficits such as pupil dilation or impaired eye movements.
Step 4: Relate the location of the hematoma to possible neurological signs. Since the hematoma is in the temporoparietal region pressing on the brainstem, symptoms like contralateral hemiparesis (weakness on the opposite side of the body), ipsilateral pupil dilation (due to oculomotor nerve compression), and possible sensory deficits may occur.
Step 5: Summarize expected clinical signs. In addition to headache and blurred vision, Colleen might experience nausea, vomiting, decreased level of consciousness, unequal pupils, weakness or numbness on one side, and irregular breathing or heart rate due to brainstem involvement.

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Key Concepts

Here are the essential concepts you must grasp in order to answer the question correctly.

Epidural Hematoma

An epidural hematoma is a collection of blood between the dura mater and the skull, often caused by traumatic head injury. It can increase intracranial pressure, compress brain structures, and lead to neurological deficits. Rapid diagnosis and treatment are critical to prevent brain damage or death.

Brainstem Function and Compression Effects

The brainstem controls vital functions such as breathing, heart rate, and consciousness. Compression of the brainstem by a hematoma can cause symptoms like altered consciousness, irregular breathing, abnormal pupil responses, and motor deficits due to disruption of these essential pathways.
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Neurological Signs of Temporoparietal Injury

Injury to the temporoparietal region can cause symptoms such as headache, visual disturbances, sensory deficits, and motor weakness. Combined with brainstem compression, signs may include cranial nerve palsies, hemiparesis, and changes in vital signs, reflecting both cortical and brainstem involvement.
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Textbook Question

A cerebrovascular accident occurs when

(a) The reticular activating system fails to function

(b) The prefrontal lobe is damaged

(c) The blood supply to a portion of the brain is cut off

(d) A descending tract in the spinal cord is severed

(e) Brainstem nuclei hypersecrete dopamine

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Textbook Question

Infants have little to no control of the movements of their head. One of the consequences of this is that they are susceptible to shaken baby syndrome, caused by vigorous shaking of an infant or young child by the arms, legs, chest, or shoulders. Forceful shaking can cause brain damage leading to mental retardation, speech and learning disabilities, paralysis, seizures, hearing loss, and even death. Damage to which areas of the brain would account for the clinical signs observed in this syndrome?

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Textbook Question

What kinds of problems are associated with the presence of lesions in the Wernicke's area and the Broca's area?

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Textbook Question

A police officer has just stopped Bill on suspicion of driving while intoxicated. The officer asks Bill to walk the yellow line on the road and then to place the tip of his index finger on the tip of his nose. How would these activities indicate Bill's level of sobriety? Which part of the brain is being tested by these activities?

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