1(E): Head Injury Flashcards

1
Q

What is head injury

A

Physical damage to brain secondary to external impact

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2
Q

How is head injury classified

A
  1. Open

2. Closed

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3
Q

What is open head injury

A

Dura mater is disrupted

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4
Q

What is closed head injury

A

Dura mater remains intact

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5
Q

In which groups are head injuries more common

A

Children under-5
Adolescences
Over 65’s

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6
Q

How may a head injury present

A
  • Loss of consciousness
  • Amnesia
  • Nausea and vomitting
  • Dizziness
  • Seizures

Cushing’s triad

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7
Q

What is Cushing’s triad

A

HTN
Bradycardia
Decrease respiration

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8
Q

What are the features of anterior basal skull fracture

A

Rhinorrhoea

Racoon eyes

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9
Q

What are the features of posterior basilar skull fracture

A

CSF Otorrhoea
Battle sign
Haemotympanum

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10
Q

What is haemotympanum

A

Blood behind ear drum

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11
Q

What causes battle sign

A

Subcutaneous haematoma

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12
Q

When should TBI be suspected

A

Individual with rapidly deteriorating consciousness

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13
Q

What is primary brain injury

A

Injury at immediate time of impact

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14
Q

What is coup

A

Injury caused by contusion of the brain

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15
Q

What is counter-coup

A

Cerebral contusion opposite impact

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16
Q

What is secondary brain injury

A

Injury occurs due to inflammation and oedema following the primary injury

17
Q

How is head injury investigated in pre-hospital setting

A

ATLS approach, GCS

18
Q

what GCS should be intubated

A

GCS Less than 8

19
Q

what is recommended imaging for head injury

A

CT

20
Q

what is the criteria for CT head in one-hour

A

FVBOGGS:

Focal neurological deficit 
Vomitting 
Basal skull fracture 
Open fracture
GCS less than 15 
GCS less than 13 after 2-hours 
Seizure
21
Q

what is the criteria for CT head in eight hours

A

BAAM:

Bleeding or anticoagulant disorder
Age over-65
Anticoagulant
Mechanism of injury - high

22
Q

what other imaging may be ordered in head injury

A

X-Ray C-Spine

23
Q

what is important for head injury assessment

A

Head Injury Observations: every 30-minutes until GCS 15

24
Q

in GCS, what is motor score out of

A

6

25
Q
What are the following in the motor section 
A. GCS 6
B. 5
C. 4
D. 3
E. 2
F.  1
A

a. Obeys commands
b. Localises pain
c. Flexes from pain
d. Abnormal Flexion to pain
e. Extension to pain
f. No response

26
Q

In GCS. what is voice score out of

A

5

27
Q
What are the following in the voice 
A. 5
B. 4
C. 3
D. 2
E.  1
A
A. Orientated
B. Confused 
C. Words
D. Sounds
E. Nothing
28
Q

In GCS, what is the eye score out-of

A

4

29
Q

What are the following for eyes

a. 4
b. 3
c. 2
d. 1

A

A. Eyes open spontaneously
B. Eyes open to voice
C. Eyes open to pain
D. Eyes closed

30
Q

If a pupil is unilaterally dilated, what does it indicate

A

CN3 Palsy

31
Q

If a pupil is bilaterally dilated, what does it indicate

A

Bilateral CN3 Compression

32
Q

How is raised ICP managed in head injury

A

IV Mannitol or Hypertonic Saline

33
Q

When is ICP monitoring indicate

A

GCS 3-8

34
Q

How is cerebral oedema managed

A

Decompressive craniotomy

35
Q

What CPP is aimed for in adults

A

70mmHg