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    Head Injury Classification: Head Injuries/Head Trauma 1 - Closed (Blunt) Brain Injury

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    Clarisse Biagtan Cerame
    Head injuries range from minor scalp wounds to serious traumatic brain injuries. Scalp wounds bleed profusely but are generally minor. Skull fractures can occur with or without brain damage. Brain injuries include concussions, contusions, lacerations, and hematomas. The most serious types are epidural, subdural, and intracranial hematomas which can increase intracranial pressure and cause herniation. Diagnostic tests include CT, MRI, and angiography. Management focuses on monitoring for increased intracranial pressure, maintaining oxygen and blood flow to the brain, and surgery if needed to relieve pressure or remove bone fragments. Prevention through safety equipment and traffic laws is the best approach to reducing head

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    Head Injury Classification: Head Injuries/Head Trauma 1 - Closed (Blunt) Brain Injury

    Uploaded by

    Clarisse Biagtan Cerame
    54 views4 pages
    Head injuries range from minor scalp wounds to serious traumatic brain injuries. Scalp wounds bleed profusely but are generally minor. Skull fractures can occur with or without brain damage. Brain injuries include concussions, contusions, lacerations, and hematomas. The most serious types are epidural, subdural, and intracranial hematomas which can increase intracranial pressure and cause herniation. Diagnostic tests include CT, MRI, and angiography. Management focuses on monitoring for increased intracranial pressure, maintaining oxygen and blood flow to the brain, and surgery if needed to relieve pressure or remove bone fragments. Prevention through safety equipment and traffic laws is the best approach to reducing head

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    Head injuries range from minor scalp wounds to serious traumatic brain injuries. Scalp wounds bleed profusely but are generally minor. Skull fractures can occur with or without brain damage. Brain injuries include concussions, contusions, lacerations, and hematomas. The most serious types are epidural, subdural, and intracranial hematomas which can increase intracranial pressure and cause herniation. Diagnostic tests include CT, MRI, and angiography. Management focuses on monitoring for increased intracranial pressure, maintaining oxygen and blood flow to the brain, and surgery if needed to relieve pressure or remove bone fragments. Prevention through safety equipment and traffic laws is the best approach to reducing head

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    © All Rights Reserved
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    54 views4 pages

    Head Injury Classification: Head Injuries/Head Trauma 1 - Closed (Blunt) Brain Injury

    Uploaded by

    Clarisse Biagtan Cerame
    Head injuries range from minor scalp wounds to serious traumatic brain injuries. Scalp wounds bleed profusely but are generally minor. Skull fractures can occur with or without brain damage. Brain injuries include concussions, contusions, lacerations, and hematomas. The most serious types are epidural, subdural, and intracranial hematomas which can increase intracranial pressure and cause herniation. Diagnostic tests include CT, MRI, and angiography. Management focuses on monitoring for increased intracranial pressure, maintaining oxygen and blood flow to the brain, and surgery if needed to relieve pressure or remove bone fragments. Prevention through safety equipment and traffic laws is the best approach to reducing head

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    HEAD INJURIES/HEAD TRAUMA

    Classification
    Head Injury
     Broad classification that includes injury/trauma 1 - Closed (blunt) brain injury
    to the scalp, skull or brain.  Object did not break the skull
     Can range from a minor bump on the skull to  Does not cause damage to dura mater/skull
    serious brain injury
     Most serious form - TBI 2 - Open/penetrating head injury
     Occurs when the cranium is fractured &/or the
    SCALP INJURY membranes that surround the brain are
     Generally classified as a minor injury breached
     The scalp bleeds profusely when injured.
     Trauma may result in an abrasion, contusion, A coup injury is the result of a sudden, violent stop that
    laceration, hematoma beneath the layers of causes the brain to accelerate forward and hit the side
    tissue of the scalp and avulsion (teared off). of the skull.

    A countercoup injury, on the other hand, occurs when


    the brain accelerates forward, hits the side of the skull,
    and then bounces off the other side of the skull. In both
    cases, the brain is damaged as it rubs against the inner
    ridges of the skull.

    Scalp wounds
     potential portal of entry of microorganisms
     Area is irrigated first before the laceration is
    sutured

    Skull fractures
     A break in the continuity of the skull caused by Types of Head Injuries
    forceful trauma A - Concussion - a violent jarring/shocking injury to the
     It may occur with or without damage to the brain
    brain  temporarily affects normal brain function
     there is a transient period of unconsciousness
    Classification  person may feel dazed & may lose vision or
    1. Simple - a crack in the skull balance for a while, vomiting, slurred speech
    2. Comminuted - splintered or multiple fracture line
    3. Depressed - occur when the bones of the skull are
    forcefully displaced downward.
    4. Basilar - fracture of the base of the skull

    BRAIN INJURY
     The most important consideration in any head
    injury is whether the brain is injured.
     Bleeding in the brain that collects & clots,
    forming a bump
     In general, a rapidly developing hematoma
    even if small, may be fatal, whereas a larger
    but slowly developing one may allow
    compensation for increases in ICP.

    Classification
    A - Epidural
     between the skull & the dura mater
     an extreme emergency
     results from a skull fracture that causes a
    rupture or laceration of the middle meningeal
    artery Characterized by brief loss of
    consciousness
     IICP, herniation

    B - Contusion - a bruise of the brain


     there is some bleeding in the brain, causing
    swelling
     characterized by extravasation of blood vessels

    B - Subdural
     between the dura & the brain (arachnoid)
     usually due to trauma & ruptured veins
     symptoms of IICP develops gradually

    C - Intracerebral
     bleeding into the substance of the brain

    C - Laceration - tearing of tissues

    D - Diffuse axonal injury


     Axons are stretched & damaged
     By high-speed transportation accidents—
    associated with shaken baby syndrome
     Causes permanent damage to nerves in the
    brain

    Hematoma Causes
    Common causes  Battle’s sign (bruising over the mastoid
    1. Falls process that is typically the result of head
    2. Motor vehicle crashes trauma.) aka = mastoid ecchymosis
    3. Being struck by objects  CSF otorrhea, CSF rhinorrhea
    4. Physical assaults
    5. Accidents at work, home & outdoors
    6. While playing sports

    Highest risk of TBI:


    - 15 to 19 age group
    - Males
    Damage to the brain from traumatic injury takes 2
    forms: Assessment & Diagnostic tests
    Primary injury Secondary injury ◼Neurologic history
    initial damage to the evolves over the ensuing ◼X-ray
    brain that results from hours & days after the ◼CT scan
    the traumatic event initial injury ◼MRI
    ◼Cerebral angiography
    includes contusions, results from inadequate
    lacerations, & torn blood delivery of nutrients & Management
    vessels oxygen to the cells ◼Close observation of the patient
    ◼Monitor LOC, respiratory status & maintain patent
    airway
    Pathophysiology
    ◼Notify the physician if drainage from the ears or nose
    Brain suffers traumatic injury
    is noted.
    ↓
    ◼Maintain head elevation
    Brain swelling/bleeding inc. intracranial volume
    ◼Assess cranial nerve function
    ↓
    ◼Monitor for IICP
    Rigid cranium allows no room for expansion
    ◼Do not take aspirin, ibuprofen, and anti-inflammatory
    ↓
    medications
    Slow blood flow to brain due to inc. pressure
    ◼Diuretics,
    ↓
    ◼Anti-seizure medications
    Cerebral hypoxia & ischemia occur
    ▪ Ex, Dilantin, Phenytoin
    ↓
    Intracranial pressure continues to rise. Brain may
    ◼Surgery
    herniate
    ↓ ✔Needed to lessen intracranial pressure & brain
    Cerebral blood flow ceases swelling
    ✔Remove fractured pieces of skull
    Clinical Manifestations ✔Insert synthetic implants to protect brain tissue.
    In any serious head trauma, always assume the spinal
    cord is also injured. The best approach to head injury is
    PREVENTION
     Chronic or severe headaches ◼Always use safety equipment during activities that
     Nausea & vomiting could result in head injury.
     Signs & symptoms of IICP ◼Obey traffic signals when riding a bicycle.
     Hemorrhage/fluid draining from the nose, ◼Be visible
    pharynx, ears, conjunctiva ◼Use age-appropriate car seats or boosters for babies
     Weakness & paralysis & young children.
     Decreasing LOC ◼Make sure that children have a safe area in which to
     Decreased sensation, visual disturbances, play.
    seizure ◼Do not drink & drive
     Memory loss, personality & behavior changes
    First Aid
    ◼For mild head injury:
    1. No specific treatment is needed.
    2. Close monitoring is needed.
    3. When person is sleeping, wake him/her q 2 to 3
    hours & ask simple questions.

    ◼For moderate to severe head injury:


    1. Treat as if there is spinal injury
    2. Stop any bleeding by firmly pressing a clean
    cloth on the wound.
    3. If with skull fracture do not apply pressure
    4. If the person vomits, roll the head, neck & body
    as one unit to prevent choking.
    5. Apply ice packs to swollen areas.

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