Head Trauma Flashcards
concussion
- alteration in cerebral function without pathological changes in brain structure
- immediate impairment of neural function (consciousness, vision, equilibrium)
- transient, mostly reversible less than 6 hours
post concussive syndrome
- headache, dizziness, nausea, dysequilibrium, fatigue, impaired memory, irritability
- can last for weeks/months after a concussion
after a concussion, wait ___ weeks before returning to sports
after a concussion, wait 2 weeks before returning to sports
- sx should be completely resolved before return
- slowly increase activity again
coup contusion
bruise is directly under the impact
countercoup contusion
bruise is on the opposite site of the impact
glasglow coma score
- scale of 3(worst) -15 (normal)
- grades severity of head trauma
- must have at least 1 point in each category
consequence of severe midline shift or tentorial herniation
hemorrhagic infarcts in the midbrain
Kernohan’s Notch
- expanded hematoma
- compresses contralateral peduncle
- ipsilateral hemiparesis
cephalohematoma
- under periosteum
- calcified bumps
linear skull fracture
- usually in kids
- the fracture acts as suture lines, and are pushed apart as the brain grows
- check over time for soft boggy spot
depressed skull fracture
- skull indents
- always fix if frontal
- wait to fix if posterolateral
open depressed skull fracture
-repair dura, lobe, scalp
basilar skull fracture
- hearing loss
- CSF leak
Battle’s sign
- temporal bone fracture (basilar skull fracture)
- blood (bruise) collects in mastoid area
raccoon eyes
- anterior skull base fracture
- blood collects in eye sockets
basilar skull fracture of the temporal bone can lead to _________
basilar skull fracture of the temporal bone can lead to blood/CSF in mastoid air cells
epidural hematoma
- middle meningeal artery
- biconvex/lens shaped
- almost all have skull fracture
why are epidural hematomas less common in the elderly?
skull and dura kinda fuse together as you get older
acute subdural hematoma
- crescent shaped
- holohemispheric
- doesn’t cross midline
chronic subdural hematoma
-get older, brain shrinks, easier to break vessels
penetrating brain injury
- remove object
- clean up
- don’t need to do too much in brain
diffuse axonal injury
-tear white matter tracts, corpus callosum
shaken baby syndrome
- non accidental trauma
- causes retinal hemorrhages
treatment for increased ICP in absence of a focal mass lesion
- elevate head of bed (venous drainage)
- analgesia, mild sedation
- drain CSF
- osmotic diuretics (mannitol)
- pharmacologic paralysis
- hyperventilation
- barbiturate coma (decrease brain metabolism/blood flow)
- hemicraniectomy