Head Injury and Coma Flashcards
(27 cards)
Define head injury
- Any trauma to the scalp, skull, OR brain
Define acquired brain injury
- Damage to brain which occurs after birth from an external force (not related to a congenital or a degenerative disease)
- TBI or non-TBI
Name the non-traumatic brain injuries
- Stroke
- Tumour
- Infection
- Anoxia
- Toxic or Metabolic
(All acquired BIs)
What is a traumatic brain injury?
- Another form of acq. BI
- Results in drastic life changes; cognitively, physically and psychosocially
Explain the features of a closed head injury
- Most common type
- Results from rapid acceleration/deceleration. The head is rocked and the brain follows movement of skull
- ie Diffuse Axonal Injury
Explain the features of open or penetrating wounds
- Skull opened
- Brain exposed and damaged
Explain crush injuries
- Head caught between two objects
- Damages often at base of skull and nerves of brain stem (rather than brain itself)
What’s the difference between primary injury and secondary damage?
- Prim In: damage at impact (skull fracture, bleeding, blood clots, etc)
- Sec Dam: damage that evolves over time (seizures, haematoma, increased intracranial pressure, etc)
Explain features of Primary survey- ATLS (Advanced Trauma Life Support)
ABCDE
1. Airway maintenance and cervical spine protection
2. Breathing and ventilation
3. Circulation and haemorrhage control
4. Disability- neurological status (pupils)
5 Exposure- undress patient
What might a CT scan find?
Focal Injury
- Traumatic Haematoma (extradural, subdural, intracerebral)
- Contusion
Diffuse Injury
- Diffuse axonal injury
What are focal injuries?
- Localised injuries that cause pressure to the brain
- ‘Mass lesions’ (haematomas and contusions)
Define a haematoma
- Blood clot within or on surface of brain
Define cerebral contusion
- Bruising of brain tissue
- Caused by small blood vessel leaks
What is an extradural haematoma?
- Collection of blood in ‘potential’ space between skull and meninges (dura mater)
What is a subdural haematoma?
- Collection of blood in space between dura mater and arachnoid mater
What is a sub-arachnoid haemorrhage?
- Not usually caused by head injury
- But sometimes brain damage leads to aneurysms leading to a haemorrhage
What is an intracerebral haematomas
- Burst blood vessel, causing blood to leak inside brain
- Increase in pressure damages surround brain cells
Highlight features of hydrocephalus
- Build up of fluid inside skull leading to brain sweeling
- Pressure on brain against skull damages brain tissue
- Can occur if: blocking of CSF flow, fluid isn’t properly absorbed into blood, TOO MUCH darling
- Treatment: surgically remove blockage, drain fluid
Causes of High Intracranial Pressure
- Rise in pressure of CSF
- Rise in pressure in brain cos of a mass, haemorrhage, fluid around brain or cerebral oedema
Surgical Management of TBI
- Burr holes (to drain haematoma)
- Craniotomy
- Craniectomy (bone not replaced til swelling decreases)
Consequences of TBI
- Physical, sensory, cognitive & behavioural issues
- Seizures, depression, mood changes, personality changes, aggression
- Loss of independence
- Affects pretty much everything
Role of SLT
- Communication
- Cognitive impairments
- Aphasia= ‘communicate better than they talk’
TBI= ‘talk better than they communicate’ - Apraxia
- Dysarthria
- Social skills, memory, attention
- Dysphagia
Causes of Coma
- Head injury
- Alchohol/ drugs/ meds
- Metabolic disturbance
- Neurological disease
Cerebral Cortex features
- Composed of grey and white matter
- Functions:
perception
sensation (via thalamus)
movement
vision
thought
