Head Trauma Flashcards by Denzel Gomez

● any sort of injury to the brain, skull, or scalp
● can range from a mild bump or bruise to a traumatic brain injury
● the consequences and treatments vary greatly, depending on what caused your head injury and how severe it is
● may either be closed or open:
➢ closed head injury - any injury that doesn’t break the skull
➢ open (penetrating) head injury - something breaks the scalp and skull and enters the brain

Head Injury

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any injury that doesn’t break the skull

closed head injury

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something breaks the scalp and skull and enters the brain

open (penetrating) head injury

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In general, head injuries can be divided into two
categories based on what causes them: due to
blank or due to blank

Due to Blows or Due to Shaking

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Head injuries caused by shaking are most common in blank and blank blank ; but can occur any time one experiences violent shaking

Infants and Small Children

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Head injuries caused by a blow to the head are usually associated with?

(How it happens?)

❖ motor vehicle accidents
❖ falls
❖ physical assaults
❖ sports-related accidents

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What are the 6 Major Types of Head Injury

Hematoma
Hemorrhage
Concussion
Edema
Skull fracture
Diffuse Axonal Injury (Sheer Injury)

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● a collection, or clotting, of blood outside the blood vessels
● can be very serious if it occurs in the brain
● clotting can lead to pressure building up inside the skull
● can cause loss consciousness or result in permanent brain damage

Hematoma

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● is uncontrolled bleeding
● there can be bleeding in the space around the brain, called subarachnoid hemorrhage, or bleeding within your brain tissue, called intracerebral hemorrhage
● Subarachnoid hemorrhages often cause headaches and vomiting
● The severity of intracerebral hemorrhages depends on how much bleeding there is, but over time any amount of blood can cause pressure buildup

Hemorrhage

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● occurs when the impact on the head is severe enough to cause brain injury
● thought to be the result of the brain hitting against the hard walls of the skull or the forces of sudden acceleration and deceleration
● the loss of function associated with a concussion is temporary; however, repeated concussions can eventually lead to permanent damage

Concussion

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● Any brain injury can lead to blank, or swelling
● Many injuries cause swelling of the surrounding tissues; but it’s more serious when it occurs in the brain
● the skull can’t stretch to accommodate the swelling; leads to pressure buildup in the brain, causing it to press against the skull

Edema

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● Unlike most bones in the body, the skull doesn’t
have bone marrow; this makes the skull very strong
and difficult to break
● A broken skull is unable to absorb the impact of a
blow, making it more likely that there’ll also be damage to the brain

Skull fracture

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● an injury to the brain that doesn’t cause bleeding
but damages the brain cells
● The damage to the brain cells results in them not
being able to function. It can also result in swelling,
causing more damage
● Though it isn’t as outwardly visible as other forms
of brain injury, ablank blank blank is one of the
most dangerous types of head injuries; can lead to
permanent brain damage and even death

Diffuse axonal injury (sheer injury)

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Headache
Lightheadedness
Spinning sensation
Temporary ringing in the ears
Mild confusion
Nausea
a loss of consciousness
Seizures
vomiting

Symptoms
(Minor Head Injury)

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● Balance or Coordination Problems
● Serious Disorientation
● An Inability to Focus the Eyes
● Abnormal Eye Movements
● A Loss of Muscle Control
● A Persistent or Worsening Headache
● Memory Loss
● Changes in Mood
● CSF Leakage

Symptoms
(Severe Head Injury)

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When is it Important to Seek Medical Attention
When pt experiences what? (3)

● Loss of Consciousness
● Confusion
● Disorientation

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o is a 15-point test that assesses mental status
o A high blank score indicates a less severe injury
(Note: the Lowest Score being 3 and the Highest Score being 15)

Glasgow Coma Scale (GCS)

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What is important for a pt who has just experienced a head injury needs to bring with him/her?

If its possible, patient should bring someone with him/her who witnessed the accident

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o The doctor will need to know the circumstances of the injury

o Often, if a patient suffered a head injury, he/she won’t remember the details of the accident

o If it’s possible, patient should bring someone with him/her who witnessed the accident

o It will be important for the doctor to determine if the patient lost consciousness and for how long if he she did

History Taking

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o The doctor will examine the patient to look for signs of trauma, including bruising and swelling

Physical Examination

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o The doctor will evaluate nerve function by assessing muscle control and strength, eye movement, and sensation, among other things

Neurologic Examination

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o commonly used to diagnose head injuries

o CT scan will help look for fractures, evidence of bleeding and clotting, brain swelling, and any other structural damage; are fast and accurate, so they’re typically the first type of imaging the patient receives

o MRI scan can offer a more detailed view of the brain; will usually only be ordered once the patient is in a stable condition.

Imaging tests

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it isn’t true that the patient shouldn’t go to sleep after having injured his/her head; should be woken up every blank blank or so to check for any new symptoms

2 hours

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take blank for the pain

acetaminophen

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Avoid *blank* , such as *blank* or *blank*; these can make any bleeding worse

NSAIDs, ibuprofen, aspirin

❑ Patients are at risk for *blank* in the week following the injury (Treatment for Severe Head Injury)

● anti-seizure medication

❑ Prescribed if injury has caused pressure build-up in the brain ❑ cause excretion of more fluids; can help relieve some of the pressure

● Diuretics

❑ For a very serious injury, this may be an appropriate treatment if the blood vessels are damaged ❑ When in a coma, the brain doesn’t need as much oxygen and nutrients as it normally does

● Medication for induction of coma

● necessary to prevent further damage to the brain ● goals in surgery?

❖ remove a hematoma ❖ repair the skull ❖ release some of the pressure in the skull

● the aim is to regain full brain function ● the type of *blank* will depend on what functionality was lost as a result of the injury

Rehabilitation

● the aim is to regain full brain function ● the type of *blank* will depend on what functionality was lost as a result of the injury

Rehabilitation

to regain mobility

Physical and occupational therapy

to address speaking difficulties

Speech therapy

● a mild traumatic brain injury (TBI) ● can occur after an impact to the head or after a whiplash-type injury that causes the head and brain to shake quickly back and forth ● results in an altered mental state that may include becoming unconscious ● those who participate in impact sports such as football or boxing have an increased risk ● usually not life-threatening, but can cause serious symptoms that require medical treatment

Concussion

● no physical damage to the brain; characterized by an alteration in the functioning of the brain ● results when brain moves back and forth in the

Concussion

● scattered areas of bleeding on the surface of the brain, most commonly along the undersurface and poles of the frontal and temporal lobes ● occur when the brain strikes a ridge on the skull or a fold in the dura mater, the brain’s tough outer covering ● may occur without other types of bleeding or they may occur with acute subdural or epidural hematomas

Contusion

Loss of Consciousness Disorientation Incoherent Speech Confusion Memory Loss Dazed or Vacant stare

Signs of a concussion

Headache or Dizziness Difficulty Concentrating Sensitive to Light Ringing in the Ears Fatigue Vomiting

Symptoms of a concussion

Diagnostic Procedure

➢ Physical examination ➢ MRI scan or a CT scan of the brain ➢ Electroencephalogram ➢ Special eye test (Eye Tracking)

to determine what symptoms are present

Physical examination

to check for serious injuries

MRI scan or a CT scan of the brain

in the case of seizures

Electroencephalogram

to assess if any visual changes are related to a concussion

Special eye test (Eye Tracking)

to assess if any visual changes are related to a concussion

Special eye test (Eye Tracking)

Surgery (Concussion) ● necessary to prevent further damage to the brain ● Indications? (3)

○ bleeding in the brain ○ swelling of the brain ○ a serious injury to the brain

most *blank* don’t require surgery or any major medical treatment

concussions

If the concussion is causing headaches (what meds?)

● Ibuprofen/acetaminophen

● get plenty of rest ● avoid sports and other strenuous activities ● avoid driving a vehicle or riding a bike for 24 hours or even a few months, depending on the severity of your injury ● avoid drinking alcohol (might slow recovery)

Lifestyle changes

Getting a second concussion before the first concussion is healed can cause a condition known as *blank blank blank*

second impact syndrome

causes one to experience concussion symptoms for weeks (or even months) instead of just a few days

post-concussion syndrome

may last for a few months

post-traumatic headaches

lasts for up to several months

post-traumatic vertigo or dizziness

Complications of Second Impact Syndrome:

● post-concussion syndrome ● post-traumatic headaches ● post-traumatic vertigo or dizziness ● brain injuries from multiple TBIs

Most people completely recover from their concussions, but it may take *blank* for the symptoms to disappear.

Months

In rare instances, people experience *blank blank blank* that are more lasting

emotional, mental, or physical changes

Repeat concussions should be avoided because even though they are rarely fatal, they can increase the chances of getting *blank blank blank*

permanent brain damage

● a break in the skull bone ● may also be called a traumatic brain injury or TBI ● A mild break may cause few problems and heal over time; more severe breaks can lead to bleeding in or around the brain, brain damage, leaking of CSF, infection, and seizures

Skull Fracture

What are the type of Skull Fracture (4)

Linear Skull Fracture Depressed Skull Fracture Skull Base Fracture Penetrating Skull Fracture

- a break in the bone, but the bone does not move out of place.

Linear skull fracture

- a break in the bone, but the bone does not move out of place.

Linear skull fracture

- part of the skull bone is sunken in from the injury; needs surgery

Depressed skull fracture

- a break in the bone at the bottom of the skull (+) Battle’s sign – bruising behind the ears (+) raccoon eyes – bruising around the eyes (+) CSF leakage - because of a tear in part of the covering of the brain

Skull base fracture

bruising behind the ears

Battle’s sign

bruising around the eyes

raccoon eyes

because of a tear in part of the covering of the brain

CSF leakage

because of a tear in part of the covering of the brain

CSF leakage

- a break from something going through the bone, such as a bullet, blade, or blast fragments - often causes severe injury and bleeding in the brain

Penetrating skull fracture

The most common causes of skull fracture in adults are:

○ A fall ○ Motor vehicle accident ○ Being hit with an object ○ Physical assault ○ Sports injury

Symptoms of Skull Fracture

Confusion Bleeding from the head Dizziness Nausea and vomiting Poor memory Loss of consciousness Feeling very tired Seizures Headache (+) Raccoon eyes, Battle’s sign Swelling on the head CSF leakage

Diagnostics Test for Skull Fracture?

❑ CT scan ❑ MRI ❑ X-ray ❑ Blood tests – to check for signs of infection

Treatment ● Most skull fractures will heal by themselves

(Simple Linear Fracture)

The healing process can take many *blank* ; pain will usually disappear in around *blank* to *blank* days.

months 5 to 10 days

For an open fracture, *blank* may be prescribed to prevent an infection. What med is needed?

antibiotics

For a severe or depressed fracture, *blank* may be needed to help prevent brain damage.

surgery

During surgery, any pieces of bone that have been pressed inwards can be *blank blank* to their correct position.

removed and returned

If necessary, *blank blank* may be used to reconnect the pieces of the skull.

metal wire or mesh

- a long, fragile tubelike structure that begins at the end of the brain stem and continues down almost to the bottom of the spine - consists of nerves that carry incoming and outgoing messages between the brain and the rest of the body - the center for reflexes - is covered by three layers of tissue (meninges)

SPINAL CORD

is covers by three layers of tissue

meninges

The spinal cord is organized into segments and named and numbered from top to bottom. Each segment marks where spinal nerves emerge from the cord to connect to specific regions of the body. Name all 5 segments

Cervical Thoracic Lumbar Sacral Coccygeal

Cervical spinal nerves (*blank blank*) control signals to the back of the head, the neck and shoulders, the arms and hands, and the diaphragm

C1 to C8

Thoracic spinal nerves (*blank blank*) control signals to the chest muscles, some muscles of the back, and parts of the abdomen.

T1 to T12

Lumbar spinal nerves (*blank blank*) control signals to the lower parts of the abdomen and the back, the buttocks, some parts of the external genital organs, and parts of the leg.

L1 to L5

Sacral spinal nerves (*blank blank*) control signals to the thighs and lower parts of the legs, the feet, most of the external genital organs, and the area around the anus.

S1 to S5

The *blank* nerve carries sensory information from the skin of the lower back

Single Nerve: coccygeal

Cervical spinal nerves (C1 to C8) control signals to the?

back of the head, the neck and shoulders, the arms and hands, and the diaphragm

Thoracic spinal nerves (T1 to T12) control signals to?

the chest muscles, some muscles of the back, and parts of the abdomen.

Lumbar spinal nerves (L1 to L5) control signals to the?

lower parts of the abdomen and the back, the buttocks, some parts of the external genital organs, and parts of the leg.

Sacral spinal nerves (S1 to S5) control signals to the?

thighs and lower parts of the legs, the feet, most of the external genital organs, and the area around the anus.

The single coccygeal nerve carries?

sensory information from the skin of the lower back.

● occurs when there is damage to the spinal cord either from trauma, loss of its normal blood supply, or compression from tumor or infection

Spinal Injury

Spinal Injury is described either as?

complete spinal cord injury or incomplete spinal cord injury

complete loss of sensation and muscle function in the body below the level of the injury

complete spinal cord injury

there is some remaining function below the level of the injury

incomplete spinal cord injury

blood supply failure to the spinal cord What happens? (3)

❖ aneurysm ❖ compression of a blood vessel ❖ prolonged drop in blood pressure

an injury to the neck C1, C2, or the mid- cervical vertebrae (C3, C4, and C5) affects the respiratory muscles and the ability to?

breathe

❑ A lower injury, in the lumbar vertebrae, may affect what?

affect nerve and muscle control to the bladder, bowel, and legs, and sexual function

is loss of function in the arms and legs.

● Quadriplegia

is loss of function in the legs and lower body.

● Paraplegia

means that there is no movement or feeling below the level of the injury.

complete injury

means that there is still some degree of feeling or movement below the level of the injury.

incomplete injury

The most common symptoms of acute spinal cord injuries?

▪ Muscle weakness ▪ Loss of voluntary muscle movement in the chest, arms, or legs ▪ Breathing problems ▪ Loss of feeling in the chest, arms, or legs ▪ Loss of bowel and bladder function

Diagnostic Procedures for Spine

❑ Physical Exam ❑ CT scan ❑ MRI ❑ X-ray ❑ Blood tests

Specific treatment for an acute spinal cord injury is based on:

o Age, overall health, and medical history o Extent of the SCI o Type of SCI o How patient responds to initial treatment o The expected course of the SCI o Patient’s opinion or preference

● Observation and medical management in the ICU ● Medicines, such as corticosteroids (to help decrease the swelling in the spinal cord) ● Mechanical ventilator ● Bladder catheter ● Feeding tube Recovery from a SCI often requires long-term hospitalization and rehabilitation. An interdisciplinary team of healthcare providers, including nurses, therapists, and other specialists work to control pain and to monitor your heart function, blood pressure, body temperature, nutritional status, bladder and bowel function, and attempt to control involuntary muscle shaking (spasticity).

Treatment Post- Surgery

Head Trauma Flashcards

(104 cards)