head trauma Flashcards
when is brain injury addressed in primary survey ?
disability
what is the primary goal of treatment for patients suspected to have TBI ?
prevent secondary brain injury - hypoxia and hypotension
what are the two types of skull fractures ?
vault and basilar
what are the signs of fracture base of thee skull ?
CSF otorrhea
CSF rhinorrhea
epistaxis
bleeding per ear
raccoon sign
battle sign
what are the classifications of head injury according to brain injury ?
focal vs diffuse
focal - epidural , subdural and intracerebral
diffuse - multiple contusions, hypoxic injury
what artery is most likely affected in epidural hematomas ?
middle meningeal artery tear
what is the classic shape of epidural hematomas ?
lenticular or biconvex
what are the symptoms of epidural hematoma ?
lucid interval followed by unconsciousness
where is the affection in subdural hematoma ?
venous tear/ brain laceration
what is the shape of subdural hematomas ?
crescent shaped and crosses the suture line
what is the presentation of subdural hematomas ?
gradually increasing headache and confusion
what are the different GCS that identify with different severities of brain injury ?
GCS -
13-15 - mild brain injury
9-12 - moderate brain injury
3-8 - severe brain injury
what are the indications for CT scan in head injury ?
1- iif the GCS is still below 15 after 2 hours of the injury
2- neurological deficit
3- open skull fracture
3- signs of basal skull fracture
4- vomiting on more than 2 episodes
5- extremes of age
6- severe headache
7- retrograde amnesia
what is the medical management for head trauma ?
controlled ventilation
goal of PaCO2 at 35 mmhg
IV fluids - hypertonic saline
mannitol
anticonvulsants
what are the types of cerebral contusions?
coup contrecoup injuries
