Head Injury

Question 1

Head Injury Primary vs Secondary

Answer 1

• Primary injury occurs at time of impact

- Secondary occurs following neurophysiological changes

Question 2

Head Injury Aetiology

Answer 2

-Falls and assaults are most common followed by RTAs

Question 3

Head Injury Cervical Spine Immobilisation Criteria

Answer 3

• GCS<15 at any time
• Neck pain or tenderness
• Focal neurological deficit
• Paraesthesia in extremities
• Clinical suspicion

Question 4

Head Injury Indications for Referral to A&E

Answer 4

• High energy
• GCS <15 at any time
• Any loss of consciousness
• Any focal neurological deficit
• Amnesia
• Persistent headache
• Any vomiting
• Any seizure
• Irritability or altered behaviour
• Fracture or visible trauma
• ≥65, PHx of neurosurgery, clotting disorder or current anticoagulation
• Social concerns, intoxication

Question 5

Head Injury Admission Criteria

Answer 5

• New significant abnormality on imaging
• Not returned to GCS 15 after imaging
• Other concerns

Question 6

Head Injury CT Indications

Answer 6

• GCS<13 on admission or <15 after 2 hours
• Signs of basal skull fracture ?
• More than one episode of vomiting
• Focal neurological deficit
• Seizures
• Anticoagulation

Question 7

Head Injury Indications for C-spine CT

Answer 7

• GCS<13
• Intubation
• Clinical suspicion and over 65, dangerous mechanism, or neuro signs

Question 8

Head Injury Complications

Answer 8

• Subarachnoid is most common haemorrhage

- Cerebral contusions common