Closed Head Injury Flashcards
When is a tetanus shot needed for a patient with a scalp laceration?
if last vaccination is > 5 yrs ago
Types of skull fractures?
- linear (hairline fracture)
- depressed
- simple, compound
- comminuted
- penetrating
CSF Rhinorrhea is a manifestation of what type(s) of skull fracture?
Frontal
CSF Otorrhea and battle’s sign are manifestations of what type(s) of skull fracture?
Temporal, Parietal, Basilar
Raccoon eyes are manifestations of what type(s) of skull fracture?
Basilar or facial
Facial paralysis is a sign of what type(s) of skull fracture?
parietal, basilar
Characteristics of Postconcussion syndrome?
- lasts 2 weeks to 2 months
- Persistent headache
- Lethargy
- Personality and behavior changes
- Shortened attention span, decreased short-term memory
- Changes in intellectual ability
Widespread axonal damage occurring after mild, moderate or severe injury?
Diffuse Axonal Injury (DAI)
Focal bruising of brain tissue, usually in closed head injury
contusion
coup-contrecoup is an example of what type of injury?
contusion
S/S of a brain contusion and how long should they be monitored for?
- Usually LOC, also can be stupor/confusion
- Monitor 24-48 hrs, follow-up one week
Tearing of the brain tissue often associated intracerebral hemorrhage?
cerebral lacerations
What is an Epidural Hematoma?
- Bleeding between the dura and the inner surface of the skull
- is a neurologic emergency
- Venous or arterial origin
Venous origin of an Epidural Hematoma?
often the dural sinus
Classic signs of an Epidural Hematoma?
- initial period of unconsciousness, followed by periods of LOC and consciousness
- HA, N/V
- focal findings
What is a Subdural Hematoma?
- Bleeding between the dura and arachnoid layer
- Usually venous in origin
- slowly develops a mass large enough to produce symptoms
Most common cause of a Subdural Hematoma?
the veins that drain the brain surface into the sagittal sinus
Who is at increased risk of developing a Subdural Hematoma?
the elderly and alcoholics
Categories of Subdural hematomas (SDH)?
- Acute SDH (within 48 hours)
- Subacute SDH (2-14 days)
- Chronic SDH
S/S of an Acute SDH
- within 48 hours
- Drowsy and confused
- Ipsilateral pupil dilates and becomes fixed
S/S of a Subacute SDH?
- 2-14 days
- After initial bleeding, appears to enlarge
Chronic SDH ?
- Weeks/months after a minor head injury
- Peak incidence age 60-80
- Presenting complaint often focal symptoms, not signs of increased ICP
- Delay in diagnosis in older adults
Head Injury Diagnostic Studies?
- Head CT: best tool
- MRI: can find small bleeds
- Transcranial Doppler studies: shows blood flow
- Cervical spine x-ray
Emergency care for a head injury?
- ABC’s
- assume a neck injury
- assess for injury/CSG leaks
