Cerebral Injuries Flashcards
(21 cards)
etiology of head injuries in infants
- falls and child abuse
etiology of head injury in children under 2
- falls
etiology of head injuries in preschool/school age children
- auto accidents
etiology of head injuries in older children and adolescents
- accidents involving motor vehicles, cycles, and sports injuries
- males outnumber females 2:1
priority of assessment
- airway and stabilize neck
primary cerebral injuries
- occur at time of trauma
- skull injuries
- contusion
- intracranial hematomas
- diffuse injuries
secondary cerebral injuries
- what occurs because of the trauma
- hypoxic brain damage
- inc ICP
- infection
- cerebral edema
neurological manifestations of a concussion
- impaired consciousness for a variable period of time
- HA: post concussion syndrome
- vertigo
- depressed reflexes
- anxiety
- general malaise
respiratory manifestations of a concussion
- dec respirations
cardiovascular manifestations of a concussion
- bradycardia
- hypotension
post concussion syndrome
- symptom complex may occur within days of injury and can include:
- HA
- dizziness
- fatigue
- irritability
- anxiety
- insomnia
- loss of consciousness
- memory impairment
- clinical symptoms of the following are all closely related with post concussion syndrome:
- posttraumatic amnesia
- GCS <15
- disorientation
- change in mental status
neurological manifestations of a head contusion and laceration
- possible loss of consciousness
- mild motor or sensory weakness
- HA
- vertigo
- post traumatic sz
- coma
- irritability
- restlessness
neurological manifestations of fractures
- altered skull contour
- conjunctival hemorrhage–assoc with fxs of anterior fossa
- CSF rhinorrhea/otorrhea (out of nose/ears)
- periorbital ecchymosis
- palsies of C1, C7, C8 nerves
- post traumatic sz–late sign
- coma
cardiovascular and integumentary manifestations of fractures
- hypovolemia: assoc with fxs over the lateral or sagittal sinus
- eccymosis of the base of the neck: assoc with basilar skull fx and fx over the mastoid process
list the complications of head injuries
- epidural hematoma
- subdural hematoma
- subarachnoid hemorrhage
- intracerebral hemorrhage
- cerebral edema
- post traumatic syndrome
- sz
epidural hematoma
- as the hematoma inc, the dura is stripped from the skull–>leads to forcing the underlying brain contents downward and inward as it expands
- occur infrequently in infants and children, but when they do, they are usually caused by child abuse (shaken baby) in the infant and child and MVCs in the adolescent
- usually arterial in origin–>leads to rapid brain decompression
neuro manifestations of epidural hematoma
- momentary unconsciousness–>followed by a normal period for several hours, then lethargy or coma due to blood accumulation in the epidural space
- lethargy and coma due to blood accumulation in epidural space and compression of brain
- cushing’s triad is late sign of impending brain herniation
resp, cardio, GI manifestations of epidural hematoma
- resp depression
- apnea
- bradycardia
- vomiting
subdural hematoma
- bleeding b/w the dura and arachnoid matter
- more common than epidural hematomas in children
- peak incidence at 6 mos of age
- often due to child abuse–shaken baby
neuro manifestations of subdural hematoma
- HA–>irritable, fussy
- loss of consciousness
- focal sz
- u/l pupillary dilation
- hemiparesis
- agitation
- drowsiness w/ confusion
- progressive slowing of thinking
submersion injury
- major cause of unintentional injury–>related death in kids 1-4 yo
- most organ systems will be affected
- all children who have a submersion injury should be admitted for observation
- b/c symptoms/complications may not show up for 24 hrs
- problems seen with submersion injury:
- hypoxia and asphyxiation–>#1 priority!
- aspiration
- hypothermia
