Management of Head injury Flashcards
What is the pathophysiology of head injury?
release of excitatory amino acids
binding to receptors
release of intracellular calcium, activation of phospholipase, breakdown of cell membrane, cell swelling and apoptosis activation
What two “I’s” are involved in secondary brain injury?
inflammation
ischaemia
Is secondary brain injury preventable?
sometimes
What is the monro-Kellie hypothesis?
An increase in volume of one component must produce a decrease in another component otherwise the ICP will rise
What is the formula for cerebral perfusion pressure?
CPP = MAP - ICP
What is normal adult ICP?
9-11mmHg
What is normal CPP?
70-85mmHg
What two types of head injury are there?
open
closed
What sign is seen in anterior skull base fracture?
panda eyes
What sign is seen in middle cranial fossa base of skull fractures?
Battle sign
How is consciousness assessed?
Glasgow Coma Scale
What is the definition of coma?
do not open eyes
do not obey commands
do not speak
How long does it take before neuronal damage takes place in circulatory arrest?
5 minutes
When should you request a head CT in trauma?
skull fracture
not orientated
focal neurology
taking anti-coagulants
What is the commonest cause of extradural haematoma?
lateral blow to the skull and rupture of the middle meningeal artery
