Chapter 12, Problem 5CCS

39-Year-Old Female with Traumatic Brain Injury

Margaret Bryans, a 39-year-old female, lost control while skiing and hit her head on a tree. She regained consciousness en route to the hospital and appeared agitated and combative. Paramedics observed that she had a right hemiparesis (muscle weakness), with a nearly complete paresis of her right upper extremity and a partial paresis of the right lower extremity. A head CT scan revealed an acute subdural hematoma and an extensive subarachnoid hemorrhage. Doctors noted that she was able to follow commands from medical personnel. However, she could only speak haltingly, using simple words.

Surgery to remove large clots from the subarachnoid space was performed immediately. Two weeks after the surgery, she showed significant improvement in her speech and motor function.

5. NCLEX-STYLE Mrs. Bryan’s subdural and subarachnoid bleeding most likely interfered directly with which of the following?

a. The blood supply to the scalp

b. The blood supply to the cerebral cortex

c. The removal of cerebrospinal fluid

d. The creation of cerebrospinal fluid