7. Head injuries Flashcards
1
Q
Some of the causes of head injuries (3)
A
- falls
- road traffic collisions
- blows from heavy objects
2
Q
Besides the brain, what else is involved in head injuries (3)?
A
- other layers are involved as well, ex.: scalp, skull, meninges
3
Q
Surface injuries are usually due to?
A
Blunt force trauma (abrasions, bruises, lacerations)
4
Q
External injuries indicate at least ….. ?
A
there has been some impact on the head and the possibility of internal damage
5
Q
What are weak and strong areas of the skull (4)?
A
Weak areas (more likely to fracture) are front and sides.
Strong areas are top and back.
6
Q
Linear fracture
A
- a fracture which runs as a long line through the skull, either in the vault or base
- usually is from an impact against a broad surface
7
Q
Localised fracture
A
- from an impact where force is concentrated in small area
- bone may be broken into multiple pieces (comminuted) or pushed inwards by the force (depressed)
8
Q
Internal damage from fracture consists of (2)
A
- intracranial haemorrhage
- direct trauma to the brain
9
Q
Intracranial haemorrhage types (4)
A
- extradural (skull and dura)
- sub-dural (dura and arachnoid)
- sub-arachnoid (arachnoid and pia)
- intra-cerebral (brain)
10
Q
Extra-dural haemorrhage (5)
A
- not a natural space
- 90% associated with fracture (temporal bone and middle meningeal artery)
- haemorrhage is space occupying and begins to press on the brain
- most are due to direct impact to the head
- typically person is initially awake (lucid interval) eventually becomes unconscious
11
Q
Sub-dural haemorrhage (7)
A
- much more common
- from deceleration impact
- space occupying and slow
- bleeding is usually only on one side
- the commonest cause is fall
- lucid interval is common
- older people can develop chronic sub-dural haemorrhage
12
Q
Sub-arachnoid haemorrhage (4)
A
- not primary space occupying (patchy and diffuse)
- usually in association with bruising or tearing of the surface of the brain itself
- clinical effects are more related to brain damage than to the bleeding
- most commonly seen as a part of head injury in road traffic accidents or fall from height
13
Q
Berry aneurysm (3)
A
- form of sub-arachnoid haemorrhage
- occurs naturally as cause of sudden death
- due to a rupture of an area of congenital weakening in a blood vessel at the base of the brain
14
Q
Intra-cerebral haemorrhage (4)
A
- bleeding into brain due to direct trauma
- usually associated with skull fracture
- severe injury
- very different from cerebral haemorrhage which occurs naturally as cause of stroke and sudden death where the haemorrhage is usually situated in basal ganglia and associated with hypertension
15
Q
Effects of intracranial haemorrhage (extradural and subdural)
A
- only skull opening is foramen magnum at the base
- space-occupying haemorrhages cause raised intracranial pressure
- base of the brain is forced downwards into the foramen magnum
- this creates pressure on the brainstem and secondary haemorrhage in the pons
- results is death if pressure is not relieved
