6: Management of head injury Flashcards

(33 cards)

1
Q

What is the concept of a secondary head injury?

A

All the stuff that happens to the brain after a primary insult

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2
Q

What is the normal range of ICP?

A

9 - 11 mmHg

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3
Q

What is the Monroe Kellie hypothesis?

A

Skull is a fixed volume, so if the volume of one part e.g blood increases the volume of something else must decrease, otherwise the pressure increases

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4
Q

How is CPP calculated?

A

MAP - ICP

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5
Q

What should CPP be kept above?

A

60 mmHg

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6
Q

The body is able to ___ CPP to an extent.

A

autoregulate

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7
Q

What is a classical appearance associate with anterior cranial fossa fracture?

A

Racoon eyes

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8
Q

What is a classical appearance associated with posterior cranial fossa fracture?

A

Battle sign over mastoid

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9
Q

Racoon eyes and the Battle sign are bruises associated with ___ ___ ___ fractures.

A

base of skull

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10
Q

Base of skull fractures are usually ___ fractures.

A

compound

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11
Q

Why type of herniation causes a third nerve palsy?

A

Transtentorial (Uncal) herniation

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12
Q

Which type of brain herniation causes Cushing triad and imminent death?

A

Tonsilar herniation

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13
Q

Which tool is used to assess head injury patients?

A

Glasgow Coma Score

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14
Q

Where should you try to evoke a pain response when taking a patient’s GCS?

A

Supraorbital notch

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15
Q

What are the possible scores for the GCS?

A

3 - 15

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16
Q

Why is 3 the minimum GCS score?

A

1 is the minimum score for each of the three domains

17
Q

What are the criteria to say someone is in a coma?

18
Q

Which score or less equates to a coma on the GCS scale?

19
Q

All patients with a GCS less than 8 should be considered for ___.

20
Q

What social factors are involved in many mild head injuries?

A

Alcohol

Social isolation

21
Q

hypoxia

hypotension

raised ICP

22
Q

Which approach is used to treat patients with acute head injuries?

23
Q

Which investigation is used for patients with suspected head trauma?

24
Q

Any patient taking ___ drugs should be scanned following a head injury.

A

anticoagulant

25
look into extradural and intramural haemorrhages
26
How is cerebral blood demand reduced in patients with acute head injuries?
27
CPP needs to be kept above ___ mmHg in patients with acute head injuries.
\> 60 mmHg
28
Which drug can be given acutely to reduce ICP and treat symptoms of tonsilar herniation?
Hypertonic saline used to be mannitol
29
People who have had head injuries may develop which recurrent neurological disorder?
Epilepsy
30
What may leak from the nose or ears in patients with acute head injury?
CSF
31
Brain dead patients are prime candidates for which program (if they give their permission)?
Organ donation
32
Brain dead patients with brain tumours can be considered for organ donation unused which circumstance?
No metastasis elsewhere
33
look over brain stem death testing