Head Injury Flashcards
(27 cards)
what is the commonest cause of trauma death?
head injuries
what is primary head injury?
occurs at time of injury
what is secondary head injury ?
occurs after primary injury event
what is a concussion?
primary head injury and temporary decrease in brain function
what are the symptoms of concussion?
headache, nausea, vomiting, confusion, visual symptoms, amnesia
what is diffuse axonal injury?
primary brain injury when shearing forces disrupt axons
what are the symptoms of diffuse axonal injury ?
coma and persistent vegetative state
autonomic dysfunction - fever, HTN, sweating
what are the symptoms of a focal contusion of the brain
focal neurological deficit
what are the different types of intracranial haemorrhages ?
extradural
intradural
subarachnoid
parenchymal haemorrhage
state some causes of secondary brain injury?
hypoxia hypercapnoea hypotension increased ICP infection
what is the Munroe kelly doctrine ?
the cranium is a rigid box and therefore a total volume of intracranial contents must remain constant if ICP is not to change
what is a complication of increased ICP
herniation
what three steps should be taken to prevent vicious circle of increasing cerebral blood flow?
ventilate to normocapnoea (4.5KPa)
IV fluid to normovolaemia
mannitol bolus
what are the three symptoms of cushing reflex?
hypertension
bradycardia
irregular breathing
what questions should be asked for a head injury Hx?
loss of consciousness amnesia nausea/vomiting fits focal neurology - speak, vision, hearing mechanism of injury drugs Hx
what would be some clinical sign of a basal skull fracture ?
CSF rhinorrhoea and otorrhoea
battle sign
pando sign
haemotypmanum
what is haemotypmanum ?
blood within the middle ear behind the ear drum which suggests a basal skull fracture
what test can be done to check for CSF rhinorrhoea and otorrhoea ?
drip the fluid leaking from nose and ears onto a cloth and over time there should be a halo sign with the blood remaining in the centre and the CSF spreading out over a greater radius
testing for what will a halo sign be seen?
CSF in fluid
- for example during a basal skull fracture
what is a battle sign?
bruised mastoid
what is pando sign?
bilateral orbital bruising
when should a CT scan be done?
basal fracture amnesia >30mins retrograde neurological deficit GCS <13 at scene vomiting >1
what blood tests should be done for basal fracture ?
glucose FBC U&E clotting EtOH level ABG
how often should neuro obs be taken ?
every 30mins until GCS 15
