2. INTRODUCTION
•The most important consideration in any head injury is
whether the brain is injured. Even seemingly minor
injury can cause significant brain damage secondary to
constricted blood flow and decreased tissue perfusion.
The brain cannot restore oxygen or glucose to any
significant degree.
5. INVESTIGATIONS
•NECT Brain
Multiple hemorrhagic contusions noted on bilateral
cerebral hemispheres ,subdural hemorrhagic noted along
the parietal temporal convexity, intraventricular bleed,
subarachnoid hemorrhage noted in bilateral
frontotemperoparietal lobes, fracture noted in mastoid
right temporal bone extending to right midline ear
cavity.
6. TREATMENT PLAN
•Tigecycline 50mg BD
•Levipil 500mg BD
•Modalert 10mg OD
•Syp. Neurofit 5ml BD
•Tolvaptan 15mg OD
•Admenta 5mg BD
•Desmopressin nasal spray
1 puff
•Pantocid 40mg OD
•IVF NS 1 L/day
•RTF 150ml/4th hrly
10. MEANING
• Injuries to the head involve trauma to the scalp, skull and brain.
Brain injury is an insult to the brain that is capable of producing
physical, intellectual, emotional, social and vocational changes.
• Clients with traumatic head injuries often have other major injuries
including injury to the facial structure, lungs, heart and bones.
Facial fractures and lung injuries may contribute to respiratory
insufficiency, airway obstruction and decreased ability to breathe.
11. INCIDENCE
•It is estimated that nearly 1.5 to 2 million persons are
injured and 1 million succumb to death every year in
India. Road traffic injuries are the leading cause (60%)
of TBIs followed by falls (20-25%) and violence (10%).
Alcohol involvement is known to be present among 15-
20% of TBIs at the time of injury.
16. CLINICAL MANIFESTATIONS
• Headache
• Light headedness
• A spinning sensation
• Mild confusion
• Nausea
• Temporary ringing in the ears
• Loss of conciousness
• Siezures
• Vomiting
• Balance and coordination
problems
• Serious disorientation
• Inability to focus the eyes
• Abnormal eye movements
• A loss of muscle control
• A persistent or worsening
headache
• Memory loss
• Changes in mood
• Leaking of clear fluid from the
ear or nose
17. DIAGNOSTIC STUDIES
• History collection
• Physical assessment
• Glasgow coma scale
• Imaging test
• Blood studies
21. NURSING MANAGEMENT
• Inefficient tissue perfusion related to cerebral hemorrhage as
evidenced by mental status changes
• Acute confusion related to increased cranial pressure as evidenced
by observation
• Impaired skin integrity related to shifting of fluid from
intravascular to interstitial space as evidenced by pressure ulcers
and dry flaky skin
• Deficient knowledge related to lack of experience with head injury
as evidenced by verbalization
22. COMPLICATIONS
• Altered consciousness
• Physical complications include seizures, fluid buildup in the brain,
infections, blood vessel damage, headaches, vertigo
• Traumatic brain injuries at the base of the skull can cause nerve
damage (cranial nerves)
• Intellectual problems: cognitive, executive functioning,
communication, behavioural, sensory, emotional problems and
degenerative brain disease.
23. PROGNOSIS
• Recovery from a TBIs is highly individualized.
• There are several different factors that can influence a patient’s recovery like
additional injuries
age
past TBIs
stress
support system.
