Trauma Flashcards
Leading cause of death under
craniocerebral trauma
Coup-coutrecoup injury:
on the side of the injury and on the other side of the injury, because the brain is a gelatinous substance that accelerates and decelerates and collides with cranial vault.
Contusion:
bruising on the surface brain due to extravasation of blood secondary to injury
Epidural hematoma:
Arterial bleed, typically of the middle meningeal artery, into the potential space between the dura and the skull. Emergency. Typically do to blow to head. Can have lucid interval followed by rapid neurological deterioration. Rapid midine shift, herniation, death.
Subdural hematoma:
Venous bleed, typical of bridging veins / arachnoid granulations, and can be associated with milder head injuries.
Focal neurological signs, confusion, ataxia, and seizures that develop over hours to days, and often happens in the elderly. Pressure in the cranial vault can result in midline shift, herniation, and death.
Diffuse axonal injury:
Stretching of axons resulting from rapid acceleration and deceleration. Axons can shear, and result in bleeding. These occur in long white-matter tracts. Present with coma.
Second-impact syndrome:
Dangerous.
Rapid swelling of cerebral tissue on repeated trauma, thought to result from a failure of cerebral autoregulation.
CSF Rhinorrea/otorrea
has glucose
Battle’s Sign/ racoon eyes:
Bruising behind ear/around eyes - evidence of skull fracture
TBI effect on epilepsy:
TBI double risk of epilepsy. Seizures can occur up to two years later. Seizures in the first week don’t count.
Glascow Coma Scale:
3-15 points. 3 = deep unconsciousness. Evaluates Eye opening, Verbal response, Motor response
Admit if:
acute blood, subdural hematoma, GCS
Management for increased ICP:
- Hyperventilate
- Osmotic agents (mannitol, normal saline)
- Sedation (pentobarbital coma)
- Surgery
