Head Injuries Flashcards
(40 cards)
What is a closed head injury?
Damage to the brain without any fracture of the skull and/or penetration of dura; most often results from blunt trauma.
What is an open head injury?
Disruption of cranial vault with opening through skin and cranial bones to expose damaged brain; most often associated with firearm wounds, stab wounds, and motor vehicle or occupational accidents.
What are the two main mechanisms of trauma?
- Blunt trauma
- Penetrating trauma
What is direct trauma in the context of blunt trauma?
When a moving object hits the head, e.g., blow with a stick, baseball, or falling block of wood.
What is deceleration of the head?
When a moving head impacts a fixed object, e.g., falling on the ground.
What is inertial trauma?
Causes rotational acceleration or deceleration of the head, leading to shearing or stretching of brain tissue.
What are the layers of the scalp?
- Hairy skin
- Subcutaneous fat and dense connective tissue
- Galea aponeurotica
- Loose areolar connective tissue
- Periosteum
What are the types of scalp injuries?
- Lacerations
- Torn flap wounds
- Cut wounds
- Firearm wounds
What is a common complication of scalp wounds?
Hemorrhage due to rich blood supply and fibrous tissue preventing vasospasm.
What factors affect skull fractures?
- Force of the impact
- Site of the impact
- Striking surface area
- Head coverings
- Support of the head
- Elasticity
- Edge of causative instrument
What are the types of skull fractures?
- Fissure fracture
- Depressed fracture
- Comminuted fracture
- Cut fracture
What characterizes a fissure fracture?
It is linear, with no bone defect, occurs at the site of impact, and can extend along lines of anatomical weakness.
What is a polar fracture?
Occurs at the most bulging poles when the head is supported and receives trauma opposite to the site of support.
What is a depressed fracture?
Caused by a heavy blunt object with a localized striking surface and high momentum, occurring at the site of impact.
What is a comminuted fracture?
Characterized by radiating fissures connected by concentric fracture rings, often caused by a heavy blunt object.
What are the four types of intracranial hemorrhage (ICH)?
- Extradural (epidural) hemorrhage (EDH)
- Subdural hemorrhage (SDH)
- Subarachnoid hemorrhage (SAH)
- Pathological ICH
What is extradural (epidural) hemorrhage (EDH)?
Arterial blood accumulates between the periosteal layer of the dura and the inner skull table, typically traumatic.
What is subdural hemorrhage (SDH)?
Blood accumulates between the meningeal layer of the dura and arachnoid matter, often due to inertial trauma.
What is the difference between acute and chronic subdural hemorrhage?
- Acute SDH: Caused by sudden jarring or rotation of the head
- Chronic SDH: Caused by repeated minor trauma, more common in elderly or those with prolonged bleeding times
What is subarachnoid hemorrhage (SAH)?
Hemorrhage in the subarachnoid space, often due to the rupture of an aneurysm or extension of pathological intracerebral hemorrhage.
What is the clinical presentation of a traumatic intracranial hemorrhage?
May present with coma, fever, pinpoint pupils, and muscle paralysis.
What is concussion?
A clinical state of transient loss of consciousness due to temporary impaired cerebral functions following head trauma.
What is the treatment for concussion?
Hospitalization and observation for vital signs, pupil size, muscle tone, and symptoms for 48 hours.
What is the lucid interval?
A stage of consciousness between unconsciousness and full consciousness.
