Head Injury

Question 1

what are common causes of skull fractures

Answer 1

fall
RTA
assault

Question 2

what are open fractures

Answer 2

fractures which communicate with the skin through a wound, sinus, the ear

Question 3

epi

Answer 3

very common with head trauma
young adults
men>women

Question 4

what is the most common fracture type

Answer 4

linear parietal fractures

Question 5

what is the most common cause of a skull fracture

Answer 5

a fall

Question 6

what are the most common causes of skull fracture in children

Answer 6

fall

abuse

Question 7

what are the different types of fractures in the skull

Answer 7

linear - single fracture
comminuted - multiple fractures
depressed fractures
open fractures

Question 8

what are common causes of linear fractures

Answer 8

falls (moderate force)

Question 9

what are common causes of comminuted or depressed fractures

Answer 9

assault (high force)

Question 10

what are features of a skull fracture

Answer 10

Hx of fall, RTA, assault

non-specific symptoms such as nausea and headache

Question 11

what is battles sign

Answer 11

bruising overlying the mastoid process indicating basilar fracture (petrous part of temporal bone)

Question 12

what are raccoon eyes

Answer 12

periorbital ecchymosis
blood pooling from basilar skull fracture around the eyes
associated with fractures of anterior cranial fossa

Question 13

what does bloody discharge from the ear indicate

Answer 13

basilar skull fracture due to petrous portion of temporal bone

Question 14

what is the first thing to do when assessing a skull fracture

Answer 14

GCS

Question 15

what is the gold standard investigation for skull fracture

Answer 15

CT head

Question 16

when should a CT scan be performed

Answer 16

GCS <13
GCS <15 after 2 hours of observation
any patient with signs of skull fracture of warfarin use

Question 17

def of concussion

Answer 17

a closed head injury due to trauma which causes a change in mental status

Question 18

epi

Answer 18

young men

Question 19

aetiology

Answer 19

head trauma resulting in:

-brain rotation

Question 20

what are the most common causes of concussion

Answer 20

RTA
sports
assaults
falls

Question 21

why does the brain rotate with in concussion

Answer 21

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

Question 22

what areas of the brain are commonly affected by concussion

Answer 22

“I Fuck Corpses”

internal capsule
fornix
corpus callosum

Question 23

what are the most common structural changes seen on CT with concussion

Answer 23

cerebral contusions
epidural haematoma
subdural haematoma

Question 24

what is the WHO diagnostic criteria for concussion

Answer 24

confusion, disoreintation or LOC, post-traumatic amnesia and other short-lasting neurological abnormalities
GCS 13-15
other causes such as drugs, alcohol, medications

Question 25

what are risk factors for concussion

Answer 25

head injury
PMHx of head injury
substance abuse

Question 26

what are features of a concussion

Answer 26

Hx of head trauma

non-specific symptoms of headache, N+V
mental slowness, dizziness + balance problems, amnesia

Question 27

what is the first line investigation with concussion

Answer 27

CT head (normal) to rule out bleeding