Head injuries

Question 1

Blunt force

Answer 1

• abrasions
• bruises (or contusions) - degradation of haemoglobin
• lacerations

Question 2

Sharp force

Answer 2

• incised wounds - longer than they are deeper

- stab wounds - deeper &more narrow (damage internally)

Question 3

skull

Answer 3

1. cranium
2. bones of the face
   (mandible is considered separate)

Question 4

primary head injuries

Answer 4

• injury to scalp
• surface contusions/lacerations
• intracranial haemorrhage
• diffuse axonal injury (D.A.I)

Question 5

secondary head injuries

Answer 5

• meningitis (inflammation of meninges)
• ischaemia (reduction of blood supply)
• increased ICP (intra-cranial-pressure)
• Oedema (swelling of brain)

Question 6

skull fractures

Answer 6

• linear -straight line
• hinge (back of skull)
• comminuted -multiple pieces
• ring
• distant (impact at one point but bone breaks at another)

Question 7

basal skull fracture

Answer 7

• generally occiptal or temporal trauma
• CSF rhinorrhoea (cerebral spinal fluid drips through nose)
• Battle’s sign -mastoid process (bleeding&bruising)
• ‘panda eyes’

Question 8

cerebral contusion

Answer 8

• motion of the brain within the skull
• Pia stripped from brain (layer)
• contact “coup” - contact site (occurs from primary impact)
• opposite point impact - “contrecoup” (secondary impact)

Question 9

Meninges

Answer 9

• dura mater (most superficial)
• arachnoid mater (just below dura)
• subarachnoid space
• pia mater (below subarachnoid space, above gray matter)

Question 10

Intracranial Haemorrhage

Answer 10

• extradural haemorrhage
• subdural haemorrhage
• subarachnoid haemorrhage
• intracerebral haemorrhage

Question 11

Extradural haemorrhage

Answer 11

• Bleeding above dura but undersurface of skull

- usually MIDDLE MENINGEAL ARTERY

Question 12

Subdural haemorrhage

Answer 12

• Abover arachnoid but below dura mater
• venous in origin
• tearing of SUPERIOR CEREBRAL VEIN

Question 13

Subarachnoid haemorrhage

Answer 13

• occurs in natural disease or injury
• AV malformation or rupture of BERRY ANEURYSM
• can be associated with trauma eg. cranial fractures or cerebral lacerations

Question 14

Diffuse Axonal Injury

Answer 14

• Diffuse brain injury without obvious lesion
• can be unconscious straight away
• due to shearing rotational forces
• microscopic diagnosis (can’t be diagnosed until after death)

Question 15

Glasgow Coma Scale (GCS)

Answer 15

• eye opening (4)
• verbal response (5)
• motor response (6)

Question 16

Pneumatised bones

Answer 16

air within them (frontal, sphenoid, ethmoid)

Question 17

Zygomatic bone

Answer 17

protects from injury