Acute Head Injury

Question 1

Head injury

Answer 1

most common causes are motor vehicle accidents and falls.
death occurs at 3 points in time after the injury (immediately after, within 2 hours after, within 3 weeks after)

Question 2

Scalp Lacerations

Answer 2

the most minor type of head trauma.
scalp is highly vascular - profuse bleeding.
major complication is infection.

Question 3

Skull Fractures

Answer 3

can be: linear or depressed. simple, comminuted, or compound. closed or open.
location of the fracture alters the presentation of manifestations: facial paralysis, Battle’s sign (post auricular ecchymosis), Bilateral periorbital ecchymosis (raccoon eyes).

Question 4

Rhinorrhea

Answer 4

postnasal sinus drainage.
indicates that a fracture has traversed the dura in a skull fracture.

Question 5

Otorrhea

Answer 5

drainage from the ear.
indicates that a fracture has traversed the dura in a skull fracture.

Question 6

Head Trauma

Answer 6

Can be diffused or localized.
A diffuse injury (e.g. concussion or axonal injury) causes disruption of neural activity and change in LOC. may cause amnesia, headache.

Question 7

Head Trauma - post concussion syndrome

Answer 7

lasts 2 weeks - 2 months.
persistent headache, lethargy, personality and behaviour changes, shortened attention span, decreased short term memory, changes in intellectual ability.

Question 8

Head Trauma - diffuse axonal injury

Answer 8

widespread axonal damage following mild, moderate or severe TBI.
causes decreased LOC, increase ICP.
can case decortication or decerebration and global cerebral edema.

Question 9

Head Trauma - Focal (localized) injury

Answer 9

includes laceration, contusions, hematoma and cranial nerve injuries.

Question 10

Lacerations

Answer 10

involve actual tearing of the brain tissue.
often occur in association with depressed and open fractures and penetrating injuries.
generally associated with intracerebral hemorrhage.
surgical repair of lacerations is possible.
prognosis is poor with large intracerebral lacerations.

Question 11

Contusion

Answer 11

brushing of the brain tissue within a focal area. maintains the integrity of pit matter and arachnoid layers.
often develops in areas of hemorrhage, infarction, necrosis and edema.

Question 12

Epidural hematoma

Answer 12

results from bleeding between the dura and the inner surface of the skull.
neurological emergency.
venous or arterial origin.
classic signs include initial period of unconsciousness, brief lucid interval followed by decrease in LOC, headache, N/V, focal findings.

Question 13

Subdural Hematoma

Answer 13

occurs from bleeding between the dura mater and the arachnoid layer of the meningeal covering the brain.
usually venous in origin.
Subacute subdural hematoma - occurs within 2-14 days of the injury.
Chronic subdural hematoma - develops over weeks or months after a seemingly minor head injury

Question 14

Intraparenchymal Hematoma

Answer 14

occurs from bleeding within the brain tissue - usually in frontal and temporal lobes.

Question 15

Traumatic Subarachnoid Hemmorhage

Answer 15

result of traumatic forces damaging the superficial vascular structures that exist in the subarachnoid space.
increases the risk of ischemic damages following brain injury.

Question 16

Signs of Increased ICP

Answer 16

headache, blurred vision, vomiting, changes in behaviour
Cushing’s triad - (1) bradycardia, (2) irregular respirations, (3) widened pulse pressure.

Question 17

Diagnosis for head injury

Answer 17

CT scan - best test to determine craniocerebral trauma
MRI
Transcranial doppler studies - allow for measurement of CBF velocity
Cervical spin X-ray
Glasgow coma scale

Question 18

Glasgow Coma Scale

Answer 18

mild injury 13-15
moderate injury 9-12
severe injury <8