Head Injury Flashcards
What is the difference between primary + secondary brain injury due to head injury?
Primary: occurs at time of injury
Secondary: occurs due to consequence of injury
What is the normal range for adult intracranial pressure?
9-11 mm Hg
What does a patient with an anterior cranial fossa fracture look like? (buzzword)
Racoon/panda eyes
What does a patient with a middle cranial fossa fracture look like? (buzzword)
Battle sign bruising over mastoid area
No pupillary response to light suggest which cranial nerve palsy?
CN III
Brain herniation can result due to raised intracranial pressure. Describe a subfalcine herniation
Cingulate gyrus pushed under falx cerebri
Which structures are particularly at risk in a subfalcine herniation?
Anterior cerebral arteries
Paramedian cortex
Brain herniation can result due to raised intracranial pressure. Describe a transtentorial herniation
Medial temporal lobe squeezed under tentorium
Which structures are particularly at risk in a transtentorial herniation?
CN III
Posterior cerebral artery
Cerebral peduncle
Upper brainstem (later)
Brain herniation can result due to raised intracranial pressure. Describe a tonsillar herniation
Cerebellar tonsils forced through foramen magnum
Which structures are particularly at risk in a tonsillar herniation?
Brainstem
CSF outflow
A coma equates to what score on the Glasgow Coma Score?
8
When should a CT scan be requested in head trauma?
Any one of the following: Skull fracture GCS less than 15 Focal neurological signs Taking warfarin
List intensive care management of head injury
Sedation Ventilation BP management Glucose maintenance Temperature maintenance
How does sedation help in management of head injury?
Reduces cerebral metabolic rate, blood flow and ICP
