Head Injury Flashcards
what are common causes of skull fractures
fall
RTA
assault
what are open fractures
fractures which communicate with the skin through a wound, sinus, the ear
epi
very common with head trauma
young adults
men>women
what is the most common fracture type
linear parietal fractures
what is the most common cause of a skull fracture
a fall
what are the most common causes of skull fracture in children
fall
abuse
what are the different types of fractures in the skull
linear - single fracture
comminuted - multiple fractures
depressed fractures
open fractures
what are common causes of linear fractures
falls (moderate force)
what are common causes of comminuted or depressed fractures
assault (high force)
what are features of a skull fracture
Hx of fall, RTA, assault
non-specific symptoms such as nausea and headache
what is battles sign
bruising overlying the mastoid process indicating basilar fracture (petrous part of temporal bone)
what are raccoon eyes
periorbital ecchymosis
blood pooling from basilar skull fracture around the eyes
associated with fractures of anterior cranial fossa
what does bloody discharge from the ear indicate
basilar skull fracture due to petrous portion of temporal bone
what is the first thing to do when assessing a skull fracture
GCS
what is the gold standard investigation for skull fracture
CT head
when should a CT scan be performed
GCS <13
GCS <15 after 2 hours of observation
any patient with signs of skull fracture of warfarin use
def of concussion
a closed head injury due to trauma which causes a change in mental status
epi
young men
aetiology
head trauma resulting in:
-brain rotation
what are the most common causes of concussion
RTA
sports
assaults
falls
why does the brain rotate with in concussion
the head is attached to the neck, on which it pivots with head trauma
however movement of the brain is constrained therefore certain areas of the brain are subject to high strain forces
what areas of the brain are commonly affected by concussion
“I Fuck Corpses”
internal capsule
fornix
corpus callosum
what are the most common structural changes seen on CT with concussion
cerebral contusions
epidural haematoma
subdural haematoma
what is the WHO diagnostic criteria for concussion
confusion, disoreintation or LOC, post-traumatic amnesia and other short-lasting neurological abnormalities
GCS 13-15
other causes such as drugs, alcohol, medications
what are risk factors for concussion
head injury
PMHx of head injury
substance abuse
what are features of a concussion
Hx of head trauma
non-specific symptoms of headache, N+V
mental slowness, dizziness + balance problems, amnesia
what is the first line investigation with concussion
CT head (normal) to rule out bleeding
