Head injury Flashcards
What causes secondary brain injury?
Loss of blood-brain-barrier: leucocyte infiltration/inflammation
Loss of cerebral autoregulation of blood pressure - ischaemia
Loss of cerebral autoregulation of blood flow:even more ischaemia causing further brain oedema
What is the monro-Kellie hypothesis?
The skull is an inelastic closed box of constant volume
This volume consists of brain, circulating blood and CSF
An increase in volume of one component must produce a decrease in another component otherwise the ICP will rise
What makes up cerebral perfusion pressure?
Cerebral perfusion pressure = mean arterial pressure – intracranial pressure
What is the target cerebral perfusion pressure following head injury?
>60mmHg
What two types of head injury are there?
Open/penetration
Closed/acceleration-deceleration
What are the signs of an anterior cranial fossa base of skull fracture?
Sunken/panda eyes
What sign indicates a middle cranial fossa base of skull fracture?
Battles sign
What types of herniation might occur in the brain
What is the definition of a coma?
Doesn’t open eyes
Doesn’t obey commands
Doesn’t speak
Equates to a GCS of 8 or less
How is Glasgow coma score assessed?
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
What types of brain haemorrhage are there (outer to inner)?
Extradural haematoma
Subdural haematoma
Traumatic subarachnoid haemorrhage
Intracerebral contusion
Intracerebral haematoma
Intraventricular haemorrhage
What type of brain haemorrhage is this?
Extradural haematoma
What type of brain haemorrhage is this?
Extradural haematoma
What brain haemorrhages are present here?
Subdural haematoma
Intracerebral haematoma
What type of haemorrhage is present here?
Subdural haematoma
What type of brain haemorrhage is this?
Subarachnoid haemorrhage
What drug can be used to protect cerebrum following injury?
Mannitol
What is post-concussion syndrome?
A set of symptoms that may continue for weeks, months, or a year or more after a concussion
Includes: poor concentration, headache, poor memory lethargy
What is the most common type of traumatic brain injury?
Concussion
What are the signs and symptoms of concussion?
Headache
Nausea/vomiting
Dizziness
Difficulty balancing
Lack of motor coordination
Light sensitivity
What parts of the brain are most affected by rotational forces?
Midbrain and diencephalon
What are the red flag signs and symptoms for potentially serious brain injury?
Seizure
Worsening headache
Difficulty waking up
Seeing double
Problem recognizing people or places
Repeated vomiting
Focal neurological problems
Not usual self
Unequal pupil size
