Head Trauma, Cohen Flashcards
population affected most by head trauma
men
elderly now on medications like anti platelet anti coagulation
general injury causing head trauma
acceleration deceleration
strike by object
cerebral edema
Minor head trauma
moderate
severe
minor is 9-13 on glascow scale
mod: 8-12
major: <7
components of glascow scale
eye movement 4
verbal response5
motor response 6
Volume of skull limited by
brain
CSF
blood in aa and vv
Cushing reflex
hypertension and bradycardia
most dangerous traumatic hemorrhage in brain
ruptured aneurysms
contusions
small ares bleeding in brain itself
usually near surface sometimes deeper
type of bleed from tearing of bridging veins
subdrual hematoma
subdurals more common in who
elderly with more room between brain and skull
acute vs chronic subdural hematoma
chronic is seen 21 days since onset
acute if within 72 hours
Sx subdural hematoma
HA confusion hemiparesis seizures CN III palsies
CT MRI subdural hematoma
crescent
Tx if patient has clear deficits and subdural is over 3 mm thick
surgical drainage
small burr holes or full craniotomy
do all subdural hematomas shrink
some can expand and soon deteriorate
what causes delayed hydrocephalus
loss of CSF earlier
epidural hematoma
dangerous!!
can have skull fracture
middle meningeal tear
compress brain more quickly
Hx epidural hematoma
suffered serious injury with loss of consciousness immediately
Lucid interval
lost consciousness wake up then lose again
time between is lucid interaval
lens shape bleed
epidural
Tx epidural
surgical drainage!!
Concussion
head trauma producing reversible decline in brain function even without loss of consciousness
Head CT for concussion
when loss of consciousness, persistent HA or significant neurological deficit
Post concussive syndrome
persistent HA light headedness depression poor concentration irritability
