Head Trauma Flashcards
TBI def
clinically any change in mentation no matter how brief following head trauma
GCS Scale Rapid measurements
eyes, verbal, motor
decorticate
Decorticate double C so arms by chest
Flexor
tells me: problem with cervical spinal tract or cerebral hemisphere
decerebrate
arms are like es
Problem with midbrain or pons
**more severe than decorticate
3 key GCS scores
normal is 15
intubate at 8
dead at 3
ABCDE D portion
D: deficit neurological ..
pupils
gross movement
and GCS
mild TBI is
GCS 13-15
moderate TBI is
GCS 9-12
severe TBI is
GCS8 or less (intubate)
high risk criteria that suggests a CT
GCS less than 15 even after 2 hrs post injury
any suspected skull fx
Basal skull fx signs (raccoon eyes, otorrhea/rhinorrhea, battle sign, hemotypanum)
Vomit more than 2 times
Older than 65 years old
PECARN pediatric head CT criteria
if GCS is less than 15 at any point scan!!
skull fx scan!
t/f all moderate or severe tbi get scanned?
true
t/f ct cannot show concussion
true
nonoperative head injury when..
no intracranial mass lesion
treat ICP
operative tx
decompressive craniectomy or brain resection less common
gender difference epidural hematoma
male to female is 4: 1
epidural hematoma blood source
MMA
unique feature of epidural hematoma is…
lucid interval
2 common sources of bleeding for SDH
cortical laceration or tearing of bridging veins
epidural or subdural hematoma more deadly?
SDH.. although with epidural lucid interval still not good
cerebral contusion tx
non operative
maintain central perfusion pressure
reduce secondary damage
what is normal central perfusion pressure
over 50
CCP = MAP - ICP
with a higher ICP what would you expect to happen to CCP value?
it would drop..subtracting a higher number .. bad this means less blood flow to the brain
what is cushings reflex or triad?
systolic BP increase
bradycardia
with irregular respirations
sign of elevated ICP
aka cushing phenomenon etc
