Head injuries

What is countre coup

damage at opposite of impact. acute decompression causes cavitation followed by a wave of acute compression. associated with brain contusion (brain bruising)

low velocity will cause

local damage.

vegetative state :

widespread damge to the brain can result in vegetative state. although the person is unaware of the surroundings, the patient may open his or her eyes,make sounds,respond to reflexes or move. it is possible that a vegetative state can become permanent, but often indivuduals progress to minical conciouss state.

Complications of truamatic brain injury

-Altered concioussness : moderate to severe traumatic brain injury can results in prolonged or permanent changes in a person state of concioussness,awareness and responsiveness. different states of concioussness include: *COma *vegetative state *minimally conciouss state *locked in syndrome *brain death -Seizures; some may have recurrent seizures called post-truamatic epilepsy - CSF buildup in the ventricles,causing increased ICP and swelling of the brain -Infections ; penetrating wounds→meningitis -Blood vessel damage→stroke or blood clots -Nerve damage:injuries of the base of the skull can damage the cranial nerves. and result in: paralysis of facial musucle, eye movement palsy,double vision,loss of vision,anosmia,loss of facial sensation,swallowing problems. -cognitive problesm: memory -speech problems -sensory changes -behavioural problems -degenerative brain disease

CF of concussion

-Headache -dizziness -vomiting -nausea -lethargy -lack of motor coordination -difficulty balancing -visual symptoms: *light sensitivity *seing bright lights *blurred vision *double vision -tinnitus -rarely concussive convulsion occur (result of temporary loss or inhibiion of motor function) -confusion -disorienttation -loss of attention -loss of concioussness -POST TRAUMATIC AMNESIA,event following the injry cannot be recalled. -slow respons -incoherent speech - crankyness -tearfullness -inappropriate affect

eitology of countrecoup

-car accidents -shaken baby syndrome it can cause diffuse axonal injury, and rarely epidural hematoma

Brain injury,types

-concussion -coup -counte coup -contusion -diffuse axonal injury

mechanism of concussion

-it is tought that forces from the injury, disrupt the normal cellular activites in the reticular activating system located in these areas, and that this disruption produce the loss of concioussness -other parts of brain that may be affected: include the upper part of the brain stem, the fornix, the corpus callosum, the temporal lobe, and the frontal

pathogenesis of head injury

1. acceleration /decelration can cause contusion (from direct impact),subdural hemoatoma,axon and vessel shearing 2. Impact ;skull fracture ,concussion,epidural hematoma 3.Penetrating ; high and low velocity types. worse with high velocity or high missile mass. low velocity; highest damage to structes on entry/exit path high velocity ; highest damage away from missile tract

types of skull fracture

4 major types of skull fracture: 1.Linear fracture ; most common,usually require no intervention for the fracture it self 2. depressed fracture; usually comminuted (crushed/splinted ) with broken portions of the bone displaced inwards and may require surgical intervention if ther is underlying tissue damage 3.Diastatic fractures : it widens the skull and usualyl affects children under 3 years. 4. Basilar fractures; occur in the bones of the base of the skull a fracture could be simple or compound

describe simple fracture

:closed injury no need for ATB no surgery

describe minimally conciouss state:

A minimally conscious state is a condition of severely altered consciousness but with some evidence of self-awareness or awareness of one's environment. It is often a transitional state from a coma or vegetative condition to greater recovery.

describe locked in syndrome

A person in alocked in state is aware of his or her surroundings and awake,but is not able to speak or move. this person may be able to communicate with eye movement or blinking. This results from damage limited to the lower brain and brainstem.rarely occurs after trauma and is more commonly due to a stroke in that area of the brain

describe coma:

A person in coma is unconciouss, unaware of anything and unable to respond to any stimulus. this results from widespread damage to all parts of the brain. after a few days to weeks, a person may emerge from coma or enter a vegetative state. .

describe skull fracture

A skull fracture is a break in one or more of the 8 bones that form the cranial portion of the skull, usually occuring as a result of blunt forece trauma. the bone may fracture at or near the site of the impact and cause damage to the underlying physical structures contained within the skull such as the membranes,blood vessels,and brain.even in the absence of fracture

what degenerative brain diseases can traumatic head injury cause

A traumatic brain injury may increase the risk of diseases that result in the gradual degeneration of brain cells and gradual loss of brain functions, though this risk cannot yet be determined with any certainty for an individual. These include: Alzheimer's disease, which primarily causes the progressive loss of memory and other thinking skills Parkinson's disease, a progressive condition that causes movement problems, such as tremors, rigidity and slow movements Dementia pugilistica — most often associated with repetitive blows to the head in career boxing — which causes symptoms of dementia and movement problems

what is coup injury

Damge at site of impact. associated with brain contusion. skull is temporarly bent inwards and impacts the brain

describe compound fracture

Open injury; increased risk of infection, surgical debirdement within 24 hours is necessary. if ther is internal fracture into sinus ; can cause meningitis, pneumocephalus

treatment of cerebral contusion

Since cerebral swelling presents a danger to the patient, treatment of cerebral contusion aims to prevent swelling. Measures to avoid swelling include prevention of hypotension (low blood pressure), hyponatremia (insufficient sodium), and hypercapnia (increased carbon dioxide in the blood).[3] Due to the danger of increased intracranial pressure, surgery may be necessary to reduce it.[3] People with cerebral contusion may require intensive care and close monitoring.[3]

treatment of concussion

Treatment involves monitoring as well as physical and cognitive rest (reduction of such activities as school work, playing video games and text messaging). Symptoms usually resolve within three weeks, though they may persist or complications may occur

describe concussion

a trauma induced alteration in mental status that may or not involve loss of conciouss ness. no parenchymal alteration on ct. most common brain injury cp include somatic,cognitive and emotional symptoms

etiology of countrecoup

abrupt deceleration causing the brain to collide with the inside of the skull

describe AAN classification

concussion severity. grade 1: altered mental status <15 min 2 : alterede mental status >15 min grade3 : any loss of concioussness

CP of contusion

depends on the severity.minor to severe. headache confusion sleepiness dizziness loss of concioussness nausea vomiting seizures memory loss vision,speech,hearing impairement inapr.affect seizures difficulty with movement and cordianation signs depends on the contusion location in the brain

high velocity will cause

distant damage possible (due to wave compression).concussion

define headinjuries

head injury can involve scalp,skull,meninges or brain

describe basal skull fracture

not easily seen on xray,realy on clinical signs -Retroauricular eccymosis ; Battles sisgn -periorbital ecymosis ;racoon eyes -hemotympaniumm -CSF out nose (rhinorrhea),otorrhea (out ears). susepct that it is CSF halo or target sign present. beta trace proteins

describe brain injury

the mechanism of injury determines the pathology. penetrating injury (gunshot,knife) or blunt force trauma.

contusion of brain

traumatic brain injury bruise of the brain tissue due to multple microhemorrhages (small vessels bleeding into tissue)

describe scalp injury

whatever the scalp injury mechanism of action may be ther ewill be a considerable blood loss. the scalp is rich in blood supply.