Head Injury Flashcards
what is the difference between - primary brain injury - secondary brain injury
primary – occurs at the time of the incident secondary – occurs as a consequence
how does secondary brain injury occur
loss of blood brain barrier – leucocyte infiltration – inflammation loss of cerebral auto regulation of BP – ishaemia
how is cerebral perfusion pressure (CCP) calculated
CPP = MAP - ICP MAP - mean arterial pressure ICP - intracranial pressure
what is the normal range for ICP
9-11mmHg
what is the ideal CCP post head injury
>60mmHg
what has a major influence on CCP
hypotension
racoon/panda eyes is a sign of what injury
anterior cranial fossa fractures
what is a ‘battle sign’ over the mastoid area a sign of
posterior cranial fossa/ basilar skull fracture
what are the 3 parts to the Glasgow coma scale
- eye opening 2. verbal response 3. best motor response
what is the GCS scored between?
3-15
what GCS indicates a coma
sum of 8 or less
GCS scoring for eye opening
spontaneously = 4 to command = 3 to pain = 2 none = 1
GCS scoring for verbal response
orientated = 5 confused = 4 inappropriate words = 3 sounds = 2 none = 1
GCS scoring for best motor response
obeys command = 6 localises to pain = 5 flexes to pain = 4 abnormal flexion = 3 extension = 2 none = 1
when should a patient receive a CT scan with a head injury
skull fracture focal neurological signs e.g. 3rd never palsy, focal weakness GCS <15 if on anti-coagulants
what type of head injruy is this
extra-dural haematoma
what kind of brain injury is this
subdural haematoma
