6: Management of head injury Flashcards Preview

Neurology Week 4 2018/19 > 6: Management of head injury > Flashcards

Flashcards in 6: Management of head injury Deck (33)
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1

What is the concept of a secondary head injury?

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

2

What is the normal range of ICP?

9 - 11 mmHg

3

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

4

How is CPP calculated?

MAP - ICP

5

What should CPP be kept above?

60 mmHg

6

The body is able to ___ CPP to an extent.

autoregulate 

7

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

Racoon eyes

8

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

Battle sign over mastoid

9

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

base of skull

10

Base of skull fractures are usually ___ fractures.

compound

11

Why type of herniation causes a third nerve palsy?

Transtentorial (Uncal) herniation

12

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

Tonsilar herniation

13

Which tool is used to assess head injury patients?

Glasgow Coma Score

14

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

Supraorbital notch

15

What are the possible scores for the GCS?

3 - 15

16

Why is 3 the minimum GCS score?

1 is the minimum score for each of the three domains

17

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

18

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

< 8

19

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

intubation

20

What social factors are involved in many mild head injuries?

Alcohol

Social isolation

21

hypoxia

hypotension

raised ICP

22

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

ABCDE

23

Which investigation is used for patients with suspected head trauma?

CT scan

24

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

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