Term
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Definition
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Term
| head injuries : primary injury |
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Definition
bullet, blunt trauma, ect
immediate brain damage |
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Term
| head injuries : secondary injury |
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Definition
increased ICP from bleeding or swelling
ischemia, hypoxia from poor perfusion/oxygenation |
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Term
| with head injuries the issues are primarily with the... |
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Definition
| secondary injury (ie swelling) |
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Term
| traumatic brain injury mild --> |
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Definition
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Term
| traumatic brain injury moderate |
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Definition
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Term
| traumatic brain injury severe |
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Definition
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Term
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Definition
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Term
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Definition
simple
depressed
basilar skull |
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Term
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Definition
hemotypanum
CSF otorrhea or rhinorrhea
periorbital ecchymosis (raccoons eyes)
retroauricular ecchymosis (battle sign) |
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Term
| fracture on the back of the skull |
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Definition
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Term
| occur at site of head impact |
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Definition
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Term
| can occur on opposite of head impact (contracoup) |
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Definition
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Term
| can lead to intra-cerebral edema/bleeding with a rise in the ICP |
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Definition
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Term
| as we age our brains shrink and they.... |
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Definition
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Term
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Definition
common with severe TBI (GCS < 9)
between pia mater and under dura, covers the brain |
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Term
| can have a lucid interval followed by rapidly decreasing LOC, ending with unilateral neurodecifics. can lead to herniation |
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Definition
| epidural hematoma (usually arterial) |
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Term
| pushes on brain but contained with suture lines so don't usually get very big and stays in one spot |
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Definition
| epidural hematoma (usually arterial) |
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Term
| can have delayed onset up to 2 weeks |
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Definition
| subdural hematoma (usually venous) |
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Term
| below the dura matera nd around the pia so can leak and fill in the different gyri and sulcuses |
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Definition
| subdural hematoma (usually venous) |
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Term
| brain contusions can lead to.. |
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Definition
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Term
| occurs commonly in people of diffuse cerebral atrophy (older folks at risk) |
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Definition
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Term
| often associated with acceleration/deceleration forces |
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Definition
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Term
| can take up to 2 weeks before becoming symptomatic (may not have symptoms) |
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Definition
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Term
| Subdural hematoma can become... |
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Definition
| a chronic coniditon for the person |
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Term
| as increased pressure occurs (bleeding or edema) the brain contents can be forced downward towards the brainstem |
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Definition
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Term
| Brainstem compression (herniation) leads to... |
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Definition
DLOC
hyperventilation to apnea
eventual death |
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Term
| when we keep bleeding inside the brain - no place for blood to go (can't get outside of skull) --> |
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Definition
| and if we get enough blood in there it wil push the brain contents down into the foramen magnum (herniation) |
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Term
| must be maintained in order to support cerebral metabolism/function |
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Definition
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Term
| can be altered in states of hypotension or extreme HYPER-tension |
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Definition
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Term
| pressure exerted by the brain from gravity and vascular conditions |
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Definition
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Term
| intracranial pressure is normally between... |
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Definition
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Term
| has normal small fluctuations with breathing, coughing, straining, ect |
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Definition
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Term
| the average pressure in the arteries |
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Definition
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Term
| how do you calculate mean arterial pressure? |
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Definition
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Term
| pressure that "perfuses" the brain |
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Definition
| cerebral perfusion pressure |
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Term
| how do you calculate cerebral perfusion pressure |
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Definition
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Term
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Definition
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Term
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Definition
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Term
| if the MAP drops below 60 |
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Definition
| there is not enough blood pressure to overcome the ICP and thus erebral blood flow is diminished |
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Term
| if the ICP rises above 15 then... |
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Definition
structures that are non-compressible
(blood, CSF, semi-solid brain matter) push against soft brain material |
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Term
| if the brain is damaged - it swells and results in a rise in... |
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Definition
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Term
| damage to the brain can be from.... |
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Definition
| blunt force, HYPOXIA, obstructed venous outflow, ect |
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Term
| symptoms of increased ICP - Early - |
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Definition
headache
mental status change
abnormal reflexes
possible altered cranial nerve function |
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Term
| Symptoms of increased ICP - Late - |
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Definition
changes in vital signs
RR, depth
bradycardia
HTN (HR is too slow, PVR is through the roof) |
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Term
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Definition
HTN - brain tries to get more blood to flow to it
Bradycardia - body senses BP too high & tries to decrease CO
agonal respirations - occurs w/ brainstem compression (ICP) |
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Term
| Often times you see cushing triad in ICU when the brain starts swelling --> |
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Definition
| not necessarily in the ER |
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Term
| Management of head injuries |
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Definition
safety net
ABC's - don't hyperventilate - cerebral ischemia
CT scan (w/out contrast)
urgent neuro-surgical intervential (intracranial catheter to monitor/relieve pressure)
consider mannitol infusion
evaluate C-spine |
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Term
| _____ is used clinically in osmotherapy to reduce acutely raised intracranial pressure until more definitive treatment can be applied |
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Definition
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Term
| it stays in the extracellular space and "draws" fluid from edematous tissue |
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Definition
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Term
| you cannot bleed enough in your head to cause... |
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Definition
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