Traumatic Brain Injuries Flashcards

Question

what is the definition of mild traumatic brain injury? (MTBI)

Answer 1

``` Any period of LOC (< 30 min) Any minimal Amnesia Any alteration in mental state at the time of the accident, Focal neurologic deficits, which may or may not be transient. GCS score =/> 13/15 No abnormalities on CT scan No operative lesions PTA < 1 day ```

Answer 2

Complicated mild- CT scan abnormal | Uncomplicated mild- CT scan normal

Answer 3

``` Any positive CT or X-ray findings Possible drug or alcohol use Epilepsy Attempted suicide Pre-existing neurological conditions (eg, Parkinson disease, Alzheimer disease) On treatment with warfarin Coagulation disorder Lack of responsible adult to supervise Any uncertainty in diagnosis Severe Headache or neurological deficit ```

Answer 4

``` LOC 30 min to 6 hours GCS score of 9-12 Abnormal CT findings Operative/Non operative intracranial lesion PTA =1 day-1 week ```

Answer 5

``` Extra-axial hematoma Intra-axial hematoma Subarachnoid hemorrhage Penetrating brain injury Primary hypoxia Concussion Contusions DAI (diffuse anoxal injury) ```

Answer 6

Epidural hematoma | Subdural hematoma

Answer 7

Subarachnoid hemorrhage Intraparenchymal hematoma Intraventricular hemorrhage Delayed Hematoma (DTICH)

Answer 8

Direct | Contre coup injury

Answer 9

Parasagittal + Corpus Callosum + Cerebral peduncle

Answer 10

``` Hypoxia Hypo tension Free radicals Oedema (Diffuse Brain Swelling) Increased ICP Ischaemia Hydrocephalus Herniation ```

Answer 11

Communicating | Non communicating

Answer 12

``` Subfalcine transtentorial cerebral Central Cerebellar tonsillar ```

Answer 13

``` Glucose Opiods Alcohol Tricyclics IV fluids Toxicology management Seizures Ð . Electrolytes and acid base status Sedation and analgesia Ð Paracetamol ,codeine Treat ICT if suspected (M-ICT) GO AT ITS BEST ```

Answer 14

Seizure management Post Traumatic amnesia Post Traumatic agitation Infections

Answer 15

Low-risk Mild headaches, dizziness, and nausea Treatment Minimal observation after assessment Do not require routine radiographic evaluation. May be discharged if a reliable individual can monitor them ``` Moderate-risk Persistent emesis, severe headache, anterograde amnesia, LOC, or signs of intoxication by drugs or alcohol Treatment CT Head Observe for at least 8 hours Discharge if their CT scan normal Or when intoxication is cleared ```

Answer 16

ASK NEURO SURGICAL OPINION

Answer 17

Admit for Observation Patients with moderate head injury + normal CT improves in few hours. If he does not improve then repeat CT scan Neurological observations every 2 hours. Nil by mouth until alert

Answer 18

``` Prevent hypoxia and hypotension Elevation of the head - to 20-30¡ IV 0.9% N saline maintenance drip Mild analgesics (eg, paracetamol, codeine phosphate) Antiemetics if necessary Sedation if required ```

Answer 19

GCS < 4 Pa O2 < 9kPa in air (<13 in O2) Seizures Signs of Herniation

Answer 20

Elevate head to 30-45¡. Keep the neck straight Maintain normal BP (mean BP >90). Mannitol (1 g/kg IV immediately) if signs of raised ICP Insert an ICP bolt.

Answer 21

Development of agitation /abnormal behaviour Drop of 1 point in motor/verbal GCS scores and 2 points in eye opening Persisting vomiting and severe headache New or evolving neurological deficits

Answer 22

``` Unilateral/ bil dilatation of the pupils Asymmetrical pupillary reaction Motor posturing Increasing BP Falling pulse/bradycardia Increased respiration rate ```

Answer 23

``` Decreasing conscious level/GCS < 12 Multiple fractures Serious facial injury Post traumatic seizures Severe co-morbidities Significant mass effects on CT Brain swelling ```