Head Injury Flashcards

1
Q

How can the sevirity of head injuries be classified and what test is helpful in classification?

A
  • Mild (GCS > 12)
  • Moderate (GCS 9-12)
  • Severe
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2
Q

What is GCS?

A

Glasgow coma scale
ranks from 3-15

Not a good clinical scale for measuring the milder head injuries

poor discriminator in paediatrics

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3
Q

Describe a primary brain injury

A

= haemorrhage

Any time a blood vessel is broken and bleeding

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4
Q

Why is a brain haemorrhage serious?

A

blood collecting inside the skull’s confined space creates pressure on delicate brain tissues potentially causing irreparable brain damage.

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5
Q

How are brain haemorrhages managed?

A

In cases of brain haemorrhage, doctors will monitor the intracranial pressure and perform surgery to drain the fluid build-up if necessary.

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6
Q

Describe a secondary brain injury

A

= haematoma

A collection of blood in the body’s tissues (e.g. bruise/contusion)

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7
Q

How is internal bleeding categorised in head injuries?

A

Based on how deep in relation to the 3 layers of the meninges

  • epidural hematoma
  • subdural hematoma
  • subarachnoid hematoma
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8
Q

What is an epidural hematoma?

A
  • bleeding in the space below the skull bone and above the dura mater
  • onset rapid, bleeding from arteries
  • minimal brain injury
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9
Q

What injury is typically associated with epidural haematomas?

A

skull fracture

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10
Q

What is a subdural hematoma?

A
  • bleeding in the space below the dura mater and above the arachnoid mater
  • onet slow = a week or more due to no visible head injury and veins bleed slower
  • seriousness depends on amount of bleeding
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11
Q

What injury is associated with a subdural hematoma?

A

violent movements to the head resulting in torn veins

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12
Q

What is a subarachnoid hematoma?

A

bleeding in the space below the arachnoid mater and above the pia mater
- approx half will suffer some degree of life long impairment or chronic headache

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13
Q

What injury is associated with a subarachnoid hematoma?

A
  • cerebral aneurysm (stroke)

- skull fracture can also cause this

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14
Q

How are head injuries categorised?

A

classified according to:

  • mechanism
  • clinically
  • site of injury
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15
Q

What are the anatomical classifications of head injury?

A
  • focal

- diffuse

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16
Q

Describe a focal head injury

A

scalp, skull, intracranial haemorrhage (laceration/contusion)

can be widespread trauma
ranges from a simple laceration to a penetrating injury

17
Q

Describe a diffuse head injury

A

widespread throughout the brain, e.g. diffuse axonal injury (DAI), ischaemia, swelling

18
Q

Describe scalp injuries

A

laceration - a tear of the dermis or underlying tissues and galea aponeurotica (aponeurosis) of the scalp

normally cause by contact injury
can rach subcutaneous fat or bone

19
Q

Describe skull injuries

A

fractures
The more severe the head injury, the higher the underlying suspicion of skull fracture should be
however, there is no direct correlation between damage to underlying brain parenchyma and skull fractures

20
Q

What is a depressed skull fracture?

A

the inner/outer tables of the skull are no longer in continuity and the inner table points down into the brain parenchyma

  • cause injury to underlying brain parenchyma
  • associated with a large force over a small area
  • more common in children (nmostly not associated with brain injury)
21
Q

Describe an intracranial bleed

A

defined according to where the bleed is relation to the brain and meninges

  • any ic bleed becomes a space occupying lesion and is associated with raised ICP
  • can manifest with brain herniation at the severe end of the scale
22
Q

What is a extradural hematoma?

A

epidural accumulation of blood (dura separates from the skull)

23
Q

What is an ovoid clot?

A

egg-shaped clot formed by an epidural hematoma