What is the concept of a secondary head injury?
All the stuff that happens to the brain after a primary insult
What is the normal range of ICP?
9 - 11 mmHg
What is the Monroe Kellie hypothesis?
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
How is CPP calculated?
MAP - ICP
What should CPP be kept above?
60 mmHg
The body is able to ___ CPP to an extent.
autoregulate
What is a classical appearance associate with anterior cranial fossa fracture?
Racoon eyes
What is a classical appearance associated with posterior cranial fossa fracture?
Battle sign over mastoid
Racoon eyes and the Battle sign are bruises associated with ___ ___ ___ fractures.
base of skull
Base of skull fractures are usually ___ fractures.
compound
Why type of herniation causes a third nerve palsy?
Transtentorial (Uncal) herniation
Which type of brain herniation causes Cushing triad and imminent death?
Tonsilar herniation
Which tool is used to assess head injury patients?
Glasgow Coma Score
Where should you try to evoke a pain response when taking a patient's GCS?
Supraorbital notch
What are the possible scores for the GCS?
3 - 15
Why is 3 the minimum GCS score?
1 is the minimum score for each of the three domains
What are the criteria to say someone is in a coma?
Which score or less equates to a coma on the GCS scale?
< 8
All patients with a GCS less than 8 should be considered for ___.
intubation
What social factors are involved in many mild head injuries?
Alcohol
Social isolation
hypoxia
hypotension
raised ICP
Which approach is used to treat patients with acute head injuries?
ABCDE
Which investigation is used for patients with suspected head trauma?
CT scan
Any patient taking ___ drugs should be scanned following a head injury.
anticoagulant
look into extradural and intramural haemorrhages
How is cerebral blood demand reduced in patients with acute head injuries?
CPP needs to be kept above ___ mmHg in patients with acute head injuries.
> 60 mmHg
Which drug can be given acutely to reduce ICP and treat symptoms of tonsilar herniation?
Hypertonic saline
used to be mannitol
People who have had head injuries may develop which recurrent neurological disorder?
Epilepsy
What may leak from the nose or ears in patients with acute head injury?
CSF
