Head Trauma - Pfeiffer

Question 1

Primary brain injury

Answer 1

Immediate damage to brain tissue via forceful injury

Question 2

Secondary brain injury

Answer 2

Result of hypoxia or ischemia

Question 3

Things that can affect intracranial volume

Answer 3

Brain, CSF, blood vessels

Question 4

High vascular CO2 results in ____ of cerebral vessels

Answer 4

Dilation

Question 5

Low vascular CO2 results in ____ of cerebral vessels

Answer 5

Constriction

Question 6

Cerebral perfusion pressure

Answer 6

Pressure required to perfuse the brain

Question 7

How to calculate CPP?

So, increased ICP means _____ CPP

So, decreased MAP means _____ CPP

Answer 7

CPP = MAP - ICP

Decreased (already have more than normal in the skull)

Decreased (less being pushed up to brain)

Question 8

With increased ICP, what does that mean in regards to MAP?

In other words, what?

Answer 8

MAP is CRUCIAL to maintaining appropriate CPP. If MAP decreases, CPP becomes DANGEROUSLY LOW

Hypotension is NOT tolerated w/ increased ICP

Question 9

Increased ICP = _____ pulse

Why?

Answer 9

Decreased

Cushing’s response
– ICP increase –> BP increase –> pulse decrease

Question 10

In a state of brain herniation, what therapy is indicated?

Answer 10

Aggressive hyperventilation

Question 11

If an unstable fracture is obtained on head injury, what should be avoided?

Answer 11

Direct pressure

Question 12

Memory problems in concussion?

Answer 12

Short term retrograde amnesia (prior to onset)

Question 13

Severe blunt head trauma —> most common injury?

Symptoms?

Answer 13

Diffuse axonal injury

Generalized edema, unconscious, NO focal deficits, rapidly progress to coma

Question 14

_____ seems to be protective against anoxic brain injury

Answer 14

HYPOthermia

Question 15

Those at high risk for subdural hemorrhage

Answer 15

Alcoholic, elderly, anticoagulants