Head Trauma & Acute Intracranial Events Flashcards
Classificatin of head trauma/ injuries in terms of primary and secondary
Classification of head trauma/ injuries in terms of traumatic vs non-traumatic
what is the most common type of focal injury?
contusion! or bruise
Cerebral Contusion
- definition
- pathophysiology
- common areas
- “Bruising” of brain where blood mixes w/ cortical tissue due to microhaemorrhages and small blood vessel leaks.
- happens when brain strikes a bony ridge
common areas:
- were bony prominence r mostly protruded (bony ridge of ocular orbit)*
ex: inferior part of frontal lobe or anterior temporal lobe!
Pathophysiology
Trauma → Microhaemorrhages → Cerebral contusion → Cerebral oedema/Intracerebral bleed → Raised ICP → Coma
Cerebral Contusion - Coup vs Contre-coup
contre-coup= contusion that occurs at the opposite side of the impact
coup= contusion that occurs at the same side of the impact
Concussion
- definition
- pathophysiology
Definition
temporary injury to the brain caused by a bump, blow or jolt to the head w/ a temporary loss of brain function.
Pathophysiology
Trauma → Stretching and injury to axons → impaired neurotransmission, loss of ion regulation, & a reduction in cerebral blood flow →that why u get Temporary brain dysfunction
Post - Concussion Syndrome
set of symptoms that may continue for wks, months, or a year or more after a concussion.
Diffuse Axonal Injury
- definition
- pathophysiology
Definition
Shearing of interface between grey and white matter following traumatic acceleration/deceleration or rotational injuries to the brain damaging the intra- cerebral axons and dendritic connections.
Pathophysiology
Trauma → shearing of grey and white matter interface → axonal death → cerebral oedema → raised ICP → irreversible Coma.
acute axonal injury to the reticular activating system is the main reason in ppl w/ concussion that loose conciousness
likely problem
basillar skull fracture
Basilar Skull Fracture
- definition
- pathophysiology
- treatment
Definition
Bony fracture within the base of skull (temporal, occipital, sphenoid, or ethmoid bone)>> very rare! must have SEVERE head injury
common cause of death in motor sports!
Pathophysiology
Trauma → tears in the meninges → CSF leakage.
Treatment/managment
- Traumatic brain injury management (including ICP control)
- Seek & treat complications
- Elevation of depressed skull fractures
- Persistent CSF leak management → Surgery
Basilar Skull Fracture – Clinical Signs and WHY DO THEY HAPPEN
Raccoon eyes – bruising around both eyes as bleeding spreads
in soft tissue
CSF rhinorrhoea – tear within the meninges due to fracture of
sphenoid bone leading to CSF leaking out of the nose
CSF otorrhoea – tear within the meninges due to fracture of
petrous temporal bone leaking to CSF leaking out of the ear
Battle sign – bruising over the mastoid process
Haemotympanum – blood in the tympanic cavity of the middle ear
Bump – bruising and swelling due to injury
why would u get a salty taste at the back of ur mouth?
CSF can travel via nasopharynx eustachian tube
what is the scoring system used to describe the level of consciousness in a person following a traumatic brain injury?
what 3 things r we assessing for?
Glasgow Coma Scale
normal ppl>> 15/15
unconcious/ coma>> 3/15 (thats the lowest u can get to!)
what will determine whether i’ve got mild, moderate or severe head injury?
depending on what ur GCS score is after ur brain injury, & whether or not u’ve had post-traumatic amnesia and how long its lasted for, & whether or not u’ve lost conciousnes
why us GCS relevant here? what r we doing in terms of brain injury?
to see who needs an URGENT CT HEAD!
