Head trauma Flashcards
What usually causes head trauma?
Road traffick accidents, falls, vrush injuries or attacks from other animals or humans
What usually causes head trauma?
Road traffick accidents, falls, vrush injuries or attacks from other animals or humans
How can we separate head injuries?
Primary - immediate injury as a result of the mechanical damage
Secondary - develops minutes to days after injury
What constitutes primary injuries?
Contusions
Haematomas
Lacerations
Direct vascular damages causes intracranial haemorrhage and vasogenic oedema. Primary brain injury is beyond the clinicians control and the focus is on recognition, prevention and treatment of the secondary brain injury
What is the first process of compensation for increased intracranial pressure?
Isobaric spatial compensation - initial redistribution of cerebrospinal fluid from the cranial vault to the spinal compartment.
Once this process is exhausted -> secondary compensation -> blood also redistributed away. Once this is exhausted -> intracranial pressure will rise sharply
What is maintenance of cerebral function dependent on?
Adequate blood being delivered to the brain, which in turn relies on there being adequate cerebral perfusion pressure (CPP).
What is the cushings response?
A baroreceptor response which can occur when head trauma patients have increased ICP and MAP increases as a result to try to maintain perfusion to the brain
What is the most reliable empiric measure of impaired cerebral function?
Level of consciousness
What is extracranial medical treatment in head trauma cases?
- fluid therapy: recommended 0,9% NaCl
- O2
Intracranial therapy in medical treatment?
- head position - angle raised at 15-30 degrees
- hyperosmolar agents - mannitol or hypotonic saline
