Created by Chris Ramgulam
over 5 years ago
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Question | Answer |
What is a head injury? | Result of a blow or jolt to the head Result of penetration of the head by bullet or other foreign object |
What indications are there of a head injury? | Scalp wound, fracture, swelling, bruising, loss of consciousness, nasal discharge, stiff neck |
Types of Head Injuries: Scalp Lacerations | Most minor type of head trauma Profuse bleeding Major complication is infection |
Types of Skull Fractures | Linear Depressed Comminuted Open |
Locations of Skull Fractures | Frontal fracture Orbital fracture Temporal fracture Parietal fracture Basilar skull fracture |
Definition: Acquired Brain Injury | Brain damage occurring after birth not related to: a congenital disorder a developmental disability or a process of progressive damage They can be traumatic (Falls, MVC, assault, sports injury) or non traumatic (hypoxia, anoxia, tumour, toxins) |
Cycling Injuries | from 2001–2010, cycling-related head injuries decreased significantly Among the most severe cycling injury admissions 78% of those hospitalized with a head injury were not wearing a helmet. |
What are considered Mild injuries? | GCS 13-15 Concussion (change in LOC, amnesia, headache) If no loss of consciousness, D/C home with instructions re: symptoms, behaviour changes |
What are considered Moderate Brain Injuries? | GCS 9-12 CT scan, admission for close obs Significant cognitive impairment Postconcussion syndrome 2 weeks-2 months (headache, lethargy, personality/behavioural changes), decreased attention span/memory) |
What are the characteristics of Severe Brain Injury? | GCS 3-8 Contusions, intracerebral lacerations, intracranial hemorrhage Coup-contrecoup injury Diffuse axonal injury |
What is a closed head injury? | Concussion Contusion Laceration Coup- Contrecoup injury Diffuse axonal injury |
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Closed Head Injury |
What is a diffuse axonal injury? | Damage occurs after a mild, moderate, or severe brain injury Manifestations- decreased LOC, increased ICP, Decerebrate or Decorticate posturing, and global cerebral edema |
What are the classification of impairment with an Acquired Brain Injury? | Cognitive- 95.2% Behavioral- 80.1% Medical- 79.8% Sensory/ Communication- 77.8% Emotional- 76.5% Gross Motor Skills- 70.5% Activities of Daily Living- 62.1% |
Clinical Manifestations of Acquired Brain Injury? | Amnesia (loss of memory) Seizure Loss of consciousness or drowsiness Restlessness or irritability Disorientation or confusion Scalp bruising and tenderness Personality changes Diplopia Gait changes Severe head injury: Pupil changes, Papilledema, etc. |
Diagnostic Tests of Acquired Brain Injury? | GCS CT Scan MRI X-rays Positron Emission Tomography (PET scan) Transcranial Doppler studies |
What are the complications of an Acquired Brain Injury? | Epidural Hematoma: Bleeding between the dura and inner surface of the skull that is usually arterial Hemorrhage, then hematoma formation (hemiplegia, dilated pupil on ipsilateral side). It is a neurological emergency Subdural Hematoma: Venous bleeding between the dura mater and the arachnoid layer Intracerebral Hematoma: Bleeding in the brain due to tearing of small arteries and veins. Subarachnoid hemorrhage (SAH) most common Penetrating Injuries: Missile (bullet) injuries, impalement, severity of injury, infection, abscess, meningitis |
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Battle's Sign |
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Raccoon eyes and rhinorrhea |
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Otorrhea |
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Halo Sign |
Factors that predict a poor outcome with head trauma's | Early sustained hypotension, hypoxemia Intracranial hematoma Increasing age of the patient Abnormal motor responses Impaired or absent eye responses ICP levels higher than 20 mm Hg |
Health Promotion for Preventing Head Injuries | Avoid motor vehicle collisions! No texting or alcohol while driving Seatbelts, child car seat safety Helmets Sports injury prevention Work PPE Fall prevention programs Handgun safety Violence prevention programs |
What can potentially be given for drug therapy? | Diuretics Antiseizure medications Steriods Analgesia Antibiotics |
What HCP's are part of the health care team? | Nurses Physicians- Neurologist, Physiatrist, G.P. Social Worker PT/ OT Speech Therapist Family Rehabilitation case manager Teachers, Supervisors, etc. |
What tests should you monitor? | Monitor fluid intake/output Intubation of ineffective breathing Assume c-spine injury until proven otherwise Maintain body temperature (Blankets, warm fluids) v/s, neuro v/s, LOC, card rhythm, pain score ICP s & s, pupil size & reactivity Decreased cerebral tissue perfusion GCS score |
What will be part of rehabilitation? | Motor and sensory deficits Communication, memory and intellectual functioning Mental and emotional effects Nutrition Bowel and bladder management, etc. Patient- Support, Referrals Family- Participation, Support, Education |
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