Head Injury

Question 1

Name two excitatory amino acids which are released in the brain in response to head injury

Answer 1

Glutamate

Aspartate

Question 2

What happens if you get loss of the blood brain barrier following a head injury?

Answer 2

Leucocyte infiltration into the brain resulting in inflammation.

Question 3

What happens if you get loss of the cerebral autoregulation of blood pressure following a head injury?

Answer 3

Brain ischaemia

Question 4

What happens if you get loss of the cerebral autoregulation of blood flow following a head injury?

Answer 4

metabolic de coupling causing ischaemia and further brain oedema

Question 5

What is the normal ICP of an adult?

Answer 5

9-11mmHg

Question 6

How are cerebral perfusions pressure (CPP), mean arterial pressure (MAP) and intracranial pressure (ICP) related (write an equation)

Answer 6

CPP = MAP - ICP

Question 7

A patient present to A & E after a car accident. They have two very blackened eyes. What part of their skull base have they injured?

Answer 7

Anterior cranial fossa

Question 8

A patient present to A & E after a car accident. The have a “battle sign” over their mastoid area. What part of their skull has been injured?

Answer 8

Middle cranial fossa

Question 9

What are the thee things that define coma?

Answer 9

1. Does not open eyes
2. Does not obey commands
3. Does not speak

Question 10

What score or below on GCS defines a coma?

Answer 10

8

Question 11

Which 4 groups of patient with head injury need a CT?

Answer 11

1. Skull fracture
2. Not orientated (GCS less than 15)
3. Focal neurological signs
4. Taking anti coagulants (warfarin)

Question 12

What CPP are you aiming for in a patient with a head injury?

Answer 12

Above 60mmHg