MSRA: Head Injury

Question 1

What are the signs of a basal skull fracture?

Answer 1

Battles sign
Haemotympanum
CSF rhinnorhoea
CSF otorrhoea
Panda eyes

Question 2

What are the indications for CT head within 1 hour?

Answer 2

BANGS

Basal skull
Any compressed or open fractures
Neurological deficit
GCS <13 at T0 or <15 at two hours
Seizure or sick more than once

Question 3

What are the indications for CT head within 8 hours?

Answer 3

LOC or amnesia and any of the following:
- Age 65+
- Bleeding or clotting disorders
- Dangerous mechanism of injury
- More than 30 minutes of retrograde amensia immediately before the injury

Question 4

What are the key differences between subdural and extradural haematoma?

Answer 4

Subdural: increasing age and anti-coagulants, slow onset, fluctuating confusion/consciousness

Extradural: hit on side of head, rapid onset, lucid interval (worsens, then improves, then worsens again