6: Management of head injury Flashcards

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?

A
18
Q

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

A

< 8

19
Q

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

A

intubation

20
Q

What social factors are involved in many mild head injuries?

A

Alcohol

Social isolation

21
Q

hypoxia

hypotension

raised ICP

A
22
Q

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

A

ABCDE

23
Q

Which investigation is used for patients with suspected head trauma?

A

CT scan

24
Q

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

A

anticoagulant

25
Q

look into extradural and intramural haemorrhages

A
26
Q

How is cerebral blood demand reduced in patients with acute head injuries?

A
27
Q

CPP needs to be kept above ___ mmHg in patients with acute head injuries.

A

> 60 mmHg

28
Q

Which drug can be given acutely to reduce ICP and treat symptoms of tonsilar herniation?

A

Hypertonic saline

used to be mannitol

29
Q

People who have had head injuries may develop which recurrent neurological disorder?

A

Epilepsy

30
Q

What may leak from the nose or ears in patients with acute head injury?

A

CSF

31
Q

Brain dead patients are prime candidates for which program (if they give their permission)?

A

Organ donation

32
Q

Brain dead patients with brain tumours can be considered for organ donation unused which circumstance?

A

No metastasis elsewhere

33
Q

look over brain stem death testing

A