Neurological Injuries: Skull and Brain injuries Flashcards
Skull injury
T/F: Damages brain
May or may not
Skull injury
Open fracture– what is torn?
Dura
Skull injury
Closed fracture
What is torn?
Dura NOT torn
Skull injury
With basal skull fractures, you see bleeding where?
EENT
Skull injury
Battle sign
Bruising over mastoid
Skull injury
Raccoon eye
Periorbital bruising
Skull injury
Cerebrospinal rinorrhea?
Leaking spinal fluid from your nose
Skull injury
How do we tell CSF from other drainage?
CSF is positive for glucose and halo test
Skull injury
What requires surgery?
Non-depressed skull fractures usually do not require surgery
Depressed fractures do require surgery
Brain injury: Concussion
What is this?
Temporary loss of neurologic function with complete recovery
Brain injury: Concussion
How long of unconsciousness?
Will have short (maybe seconds) period of unconsciousness or may just get dizzy/see spots
Brain injury: Concussion
Teach caregiver what?
To bring client back to ED if the following occur:
- Difficult awakening/speaking
- Confusion
- Severe HA
- Vomiting
- Pulse changes
- Unequal pupils
- One-sided weakness
*All of these are signs that the ICP is going up
Brain injury: Hematomas
A small hematoma that develops rapidly may be ___, while massive hematoma that develops slowly may allow client to __
Fatal; adapt
Brain injury: Epidural hematomas
Rupture of ?
Middle meningeal artery (fast bleeder under high pressure)
Brain injury: Epidural hematomas
Patho
Injury– LOC– Recovery– Cant compensate any longer– Neuro changes
Brain injury: Epidural hematomas
Treatment?
Burr holes and remove clot; control ICP
Brain injury: Epidural hematomas
Questions to ask?
- Did they pass out and stay out?
- Did they pass out and wake up and pass out again?
- Did they see stars?
- Epidural hematoma is emergency!!!!
Brain injury: Subdural hematomas
What bleed?
Venus bleed
Brain injury: Subdural hematomas
Can be ?
Acute (fast)
Subacute (med)
Chronic (slow)
Brain injury: Subdural hematomas
Treatment?
Chronic: Imitates other conditions;
Bleeding and compensating
Neuro changes= Maxed out
Brain injury: Subdural hematomas
Acute or chronic?
Immediate craniotomy and remove clot: control ICP
What hematoma?
Artery bleed
Epidural
What hematoma
Venous bleed
Subdural hematoma
Spinal cord injury: Autonomic dysreflexia
Patho?
With upper SC injury above T6, the major complication to look for is autonomic dysreflexia or hyperreflexia
Spinal cord injury: Autonomic dysreflexia
Hypo or HTN?
Severe HTN
Spinal cord injury: Autonomic dysreflexia
HA?
Yes
Spinal cord injury: Autonomic dysreflexia
HR?
Bradycardia
Spinal cord injury: Autonomic dysreflexia
Nose
Nasal stuffiness
Spinal cord injury: Autonomic dysreflexia
Body temp
Flushing
Sweating
Spinal cord injury: Autonomic dysreflexia
Eyes
Blurred vision
Spinal cord injury: Autonomic dysreflexia
Mind
Anxiety
Spinal cord injury: Autonomic dysreflexia
Slow or sudden onset?
Sudden
*neurologic emergency!!!! If not treated promptly, HTN stroke can occur!!!!
Spinal cord injury: Autonomic dysreflexia
Causes?
Distended bladder
Constipation
Painful stimuli
Spinal cord injury: Autonomic dysreflexia
Tx?
- Sit client up to lower BP
- Treat cause (catheter, remove impaction, look for skin pressure/painful stimuli or cold draft/breeze in room)
- Teach prevention measures
