Head injury

Question 1

What CPP (Cerebral Persussion Pressure is required to perfuse the brain?

Answer 1

Aim for CPP of > 60mmHg after head injury

CPP = MAP - ICP

Question 2

what type of fractures are panda eyes and the battle sign indicative of?

Answer 2

anterior cranial fossa - “panda eyes”

middle cranial fossa - “Battle sign” over mastoid area

Question 3

Describe the scoring sytem of the glasgow coma scale

Answer 3

Eye opening spontaneously

to command

to pain

none

Verbal response orientated

confused

inappropriate words

incomprehensible sounds

none

Best motor response obeys commands

localises pain

flexes to pain

abnormal flexion

extension

none

Question 4

what is the definition of a coma

Answer 4

Do not open eyes

Do not obey commands

Do not speak

equates to a score of 8 or less

Question 5

what are the 3 things tha kill patients with head injuries?

Answer 5

Hypoxia

Hypotension

Raised Intracranial Pressure

Question 6

when should a CT scan be requested with trauma?

Answer 6

Any patient: with a skull fracture

or not orientated (GCS < 15)

or with focal neurological signs

or taking anti-coagulants (warfarin)

Question 7

what does an extradural haematoma look like?

Answer 7