Closed Head Trauma Flashcards

1
Q

What are important to check with the scalp in closed head trauma

A

stepoff

crepitus

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2
Q

What are components of ICP

A

80% brain

20% CSF & blood

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3
Q

What is Cerebral blood flow affected by

A

Hypercapnia (retaining CO2) cerebral vasodilation
Hypocapnia (loosing CO2) cerebral vasoconstriction
Hypoxia (loosing O2) cerebral vasodilation

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4
Q

What is CPP

A

Mean arterial BP (systolic+2xdiastolic/3) - ICP

CPP 45-160 mmHg

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5
Q

Transtentorial Herniation summary

A

aka uncal
Def:
rise in ICP cause uncus (temporal lobe portion) through tentorium opening

SS:
compresses CN III and corticospinal (motor) tract
ipsilateral fixed, dilated pupil
contralateral weakness of arm/leg
deteriorating LOC
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6
Q

Concussion summary

A
Def: Transient LOC or alteration conciousness
SS: Duration secs to hours
Post-concussive syndrome SS
- HA
- memory
- anxiety
- insomnia
- dizziness
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7
Q

Diffuse Axonal Injury summary

A

Def: tearing/shearing of nerve fibers (axons) at time of impact
Eval:
CT normal despite neurological deficit
Manifestations: prolonged, possibly permanent coma

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8
Q

Skull fractures gen char

A
Linear nondepressed
- no treatment
Depressed
- open or closed
- feel for crepitus/stepoff
- surgery/abx
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9
Q

Basilar skull fracture gen char

A
Def: across base temporal bone
SS:
hemotypanum
raccoon's eyes
battle's sign
CSF rhinorrhea/otorrhea
Txt:
Observe
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10
Q

Cerebral Contusion summary

A

Def: focal hemorrhagic area on brain surrounded by edema
SS:
occur on side of impact or contrecoup lesion
Eval:
CT white areas

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11
Q

Intracerebral Hemorrhage summary

A

aka parenchymal hemorrhage
Def: torn blood vessels
Cause: usually continuation from contusion

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12
Q

What is cushing’s reflex

A

hypertension and bradycardia in head injury pt

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13
Q

Evals for Closed Head injuries

A

C-spine

CT

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14
Q

Severe head injury mgmt

A
ABC
c-spine immobilize
intubate/hyperventilate
elevate head of bed to 30 degrees
correct hypotension
CT
neurosurgical evacuation?
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15
Q

Mild/moderate head injury mgmt

A
observe
admit:
- LOC
- focal neuro deficit
- seizures
- unreliable pt
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