Head Injury Presentation ; Lecture

Question 1

What is the primary objective in managing head injuries?

Answer 1

Stabilizing the patient through ABCDE assessment and addressing life-threatening conditions, including head and cervical spine injuries.

Question 2

A Glasgow Coma Scale (GCS) score is often unreliable within _________ of the event.

Answer 2

one hour.

Question 3

True/False: Withdrawal from painful stimulus is always a sign of conscious response.

Answer 3

False (it may be a spinal reflex).

Question 4

What are the key components to monitor in non-ventilated and ventilated patients with head injuries?

Answer 4

Non-ventilated: Vital signs, GCS, lateralizing signs, pupils, blood tests, and CT imaging.
Ventilated: Vital signs + ET CO₂, sedation breaks, ICP monitoring, and imaging.

Question 5

ICP monitoring is guided by the formula _________ = MAP – ICP, and cerebral perfusion pressure should be maintained between _________ mmHg.

Answer 5

CPP; 60–70.

Question 6

True/False: There is consistent evidence that ICP monitoring improves outcomes in head injuries.

Answer 6

False (studies show variable results).

Question 7

What are the steps in managing scalp lacerations in head injury patients?

Answer 7

Wound cleaning and toilet.
Gloved finger inspection.
Suturing before CT or neurosurgery.

Question 8

Mannitol is used in head injury management to reduce _________ by lowering ICP.

Answer 8

cerebral edema.

Question 9

True/False: Minor head injuries with GCS 13–15 typically require a delayed CT scan.

Answer 9

False (NICE 2014 suggests relying on neuro-assessment).

Question 10

What are the signs of raised intracranial pressure (ICP)?

Answer 10

Symptoms: Headache, vomiting, visual disturbances, unsteady gait.
Signs: Drowsiness, papilledema, upward gaze limitation, reduced visual acuity.

Question 11

Chronic subdural hematoma may require evacuation in _________ of cases, typically after a median delay of _________ days.

Answer 11

35%; 17.

Question 12

True/False: Prophylactic antibiotics are recommended for CSF leaks.

Answer 12

False

Question 13

Name two key legal aspects related to head injuries.

Answer 13

Reporting deaths to the coroner.
Compliance with DVLA regulations for driving.

Question 14

Under the Mental Capacity Act 2005, a deprivation of liberty occurs when a person is under continuous _________ and is not _________ to leave.

Answer 14

supervision; free.

Question 15

What are the four domains of rehabilitation in head injury patients?

Answer 15

Hand, leg, cognitive, and communication.

Question 16

Rehabilitation should include _________, _________, compensatory strategies, and use of _________.

Answer 16

passive; active; equipment.

Question 17

What percentage of head injuries are attributed to road traffic accidents (RTAs)?

Answer 17

Approximately 50%.

Question 18

A patient with minor head injury (GCS 13–15) is on warfarin. What is the likelihood of finding intracranial bleeding on CT?

Answer 18

20%

Question 19

In a chronic subdural hematoma, dexamethasone has been studied to reduce _________ rates.

Answer 19

reoperation.

Question 20

True/False: The presence of multiple facial lacerations or fractures above the HBL may indicate trauma rather than a fall.

Answer 20

true