Head Injury Flashcards
When do deaths occur after a head injury?
- immediately after
- within 2 hrs after
- 3 weeks after
Scalp Lacerations
Most minor head trauma
- highly vascular leads to profuse bleeding
- major complication: infection
Conjugate deviation of gaze
Inability to gaze in a single direction
Rhinorrhea or otorrhea
Indicate fracture has traveled to the dura
Concussion
Brief disruption in LOC
Amnesia
Headache
Short duration
Post concussion syndrome
2 weeks to 2 months
Persistent headache
Lethargy
Personality/behavior changes
Contusion
Bruising of brain tissue within a focal area
- closed head injury
- coup: impact against object
- contrecoup: impact with rebound
- prognosis dependent on bleeding amount
Lacerations
Tearing of brain tissue
- occur with depressed/open fractures and penetrating injuries
- intracerebral hemorrhage is associated with
- prognosis poor if large
Diffuse Axonal Injury
Widespread axonal damage after TBI
- takes 12-24 hr
- damage in: axons, basal ganglia, thalamus, brain stem
- decreased LOC, increased ICP, decebreation or decortication, global cerebral edema
Epidural hematoma
Bleeding between dura and inner skull surface
- neuro emergency
- venous or arterial origin
- initial period of unconsciousness, brief lucid interval followed by decreased LOC
- N/V, headache, focal findings
Subdural hematoma
Bleeding between dura mater and arachnoid layer
- most common: veins that drain the brain surface into the sagittal sinus
- acute: signs within 48 hrs, drowsy and confused, ipsilateral pupil dilates
- subacute: 2-14 days, hematoma enlarges over time
- chronic: wks-mos, peak in 60s-70s, often focal symptoms, mimics vascular disease/dementia in older adults
Intracerebral hematoma
Bleeding within the parenchyma
-within frontal and temporal lobes
Best diagnosis test to determine craniocerebral trauma
CT scan
