management of head trauma Flashcards
forms of trauma leading to head injury?
how do you classify types of head injury?
Mild - GCS 14-15
Moderate - GCS 9-13
Severe - GCS 3-8
symptoms of head injury?
signs of head injury?
what is the key I for head injury?
CT head
who should get CT in 1 hour of presentation?
who gets CT within 8 hrs?
what other bedside tests may be done?
what blood tests may be done?
what other imaging may be needed?
what is the conservative management?
Intubation and ventilation may be required e.g. in patients with a GCS of 8 or less or irregular breathing
Assess for cervical spine injury and immobilise if needed (see spinal injury chapter for more details)
Regular neurological observations (half-hourly until GCS is 15)
In the longer term, multidisciplinary neurorehabilitation and social support are crucial for patients with ongoing disability as a result of traumatic brain injury
medical management?
surgical management?
complications?
Herniation occurs due to raised intracranial pressure and mass effect e.g. from a large intracranial bleed.
Hypopituitarism
Post-traumatic seizures
Permanent neurological deficits
Mental health problems
Cognitive impairment
how does Herniation occur?
“Coning” is used to describe herniation of the cerebellar tonsils through the foramen magnum; this puts pressure on the brainstem causing respiratory arrest and death
The uncus of the temporal lobe can herniate through the tentorial notch - this causes compression of the oculomotor nerve leading to a unilateral “blown pupil”
