WEEK 1:TRAUMATIC HEAD INJURIES Flashcards
Describe the two types of head injuries
- Primary injury: occurs at the time of impact
2.Secondary : involves factors comprising adequate oxygenation
This is due to increased intracranial pressure resulting in hypoxia, lesions and brain oedema
What causes most of head injuries?
*TRAUMA
*fall, thermal, community assaults, interpersonal violence, drowning , road accidents
NOTE : Most traumatic injuries result in neuropsychologic impairements in survivors
Describe the monro-kellie doctrine
The Monro-Kellie Doctrine describes the relationship between the contents of the cranium and intracranial pressure
As the cranium is made from solid bone*, its structure is fixed and therefore the volume contained within cannot be changed.
Alongside the brain tissue, the other major components found within the cranium are blood (mostly venous blood from within dural sinuses) and the cerebrospinal fluid (CSF). The volume of each of these components is restricted by the fixed space within the cranium.
State the 3 components that are found in the cranium
- brain
- CSF
3.blood
Why does the monro kellie doctrine apply to babies and infants
*This concept only applies to adults, as the presence of fontanelles and open suture lines in infants that have not yet fused means there is potential for a change in size and intracranial volume
How does the body regulate increased intracranial pressure
- CSF and venous blood leave the skull to moderate the ICP
What is the normal range of intracranial pressure?
approximately 10mmHg
How does increased intracranial pressure result in death of brain cells?
- increased ICP results in LOW Cerebral blood flow as the venous blood has to leave the skull to moderate ICP as a result there is hypoxia and the brain cells end dying due to lack of oxygen
State the symptoms associated with high ICP
High VP, Slow or irregular pulse, severe headache, weakness, cardiac arrest, loss of brain stem reflexes, respiratory arrest,
What are assessments that should be done to patients with traumatic head injury
HISTORY TAKING
*presenting complain: headache, vomiting, dizziness, headache, amnesia
*mechanism of injury
*witness
*underlying conditions
*bleeding disorders
*loss of consciousness
EXAMS
*level of consciousness
*dilation of pupil
*loss of pupillary response to light
*lateralizing symptoms
*gait
Differentiate between epidural and subdural hematoma
EPIDURAL HEMATOMA
* result from tear of the middle meningeal artery due to fracture on the cranium
*usually at the site of pterygoid
*forms a lentiform
SUBDURAL HEMATOMA
*result from severe brain injuries
*from shearing of small surface underlying blood vessels of the cerebral cortex
Describe the management of the hematomas in the brain
- oxygenation
*nurse in head up position( elevated)
*Evacuate bleeds via surgery
Why is the mechanism of injury important?
- clues to CNS injury
- clues to other injuries(NON- CNS)
*consistency and plausibility
if absent, suspense abuse or non- accidental trauma
Describe the mechanisms of coup and contre coup
In head injury, a coup injury occurs under the site of impact with an object, and a contrecoup injury occurs on the side opposite the area that was
