Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.

Head injury

1,983 views

Published on

Head injury is a leading cause of death

Published in: Health & Medicine
  • Login to see the comments

Head injury

  1. 1. Head InjuryHead Injury
  2. 2. Definition of head injury Discus the types of head injury Understand the different sign and symptom of head injury Describe the pathophysiol0gy of head injury Explain the diagnostic evaluation of head injury Enlist the complication of head injury Detail the management of head injury
  3. 3. Any trauma to the scalp, skull, or brain Head trauma includes an alteration in consciousness no matter how brief
  4. 4. Causes Motor vehicle accidents Firearm-related injuries Falls Assaults Sports-related injuries Recreational accidents
  5. 5. High potential for poor outcome Deaths occur at three points in time after injury: Immediately after the injury Within 2 hours after injury 3 weeks after injury
  6. 6. Scalp lacerations The most minor type of head trauma Scalp is highly vascular → profuse bleeding Major complication is infection
  7. 7. Types of Head Injuries Skull fractures Linear or depressed Simple, comminuted, or compound Closed or open Direct & Indirect Coup & Contrecoup
  8. 8. Skull fractures Location of fracture alters the presentation of the manifestations Facial paralysis Conjugate deviation of gaze palsy Battle’s sign
  9. 9. Basal Skull fractures CSF leak (extravasation) into ear (Otorrhea) or nose (Rhinorrhea) High risk infection or meningitis “HALO Sign (Battle Sign)” on clothes of linen Possible injury to Internal carotid artery Permanent CSF leaks possible
  10. 10. Fig. 55-13
  11. 11. Minor head trauma Concussion A sudden transient mechanical head injury with disruption of neural activity and a change in LOC Brief disruption in LOC Amnesia Headache Short duration
  12. 12. Minor head trauma Postconcussion syndrome 2 weeks to 2 months Persistent headache Lethargy Personality and behavior changes
  13. 13. Major head trauma Includes cerebral contusions and lacerations Both injuries represent severe trauma to the brain
  14. 14. Major head trauma Contusion The bruising of brain tissue within a focal area that maintains the integrity of the pia mater and arachnoid layers Lacerations Involve actual tearing of the brain tissue Intracerebral hemorrhage is generally associated with cerebral laceration
  15. 15. Diffuse axonal injury (DAI) Widespread axonal damage occurring after a mild, moderate, or severe TBI Process takes approximately 12-24 hours
  16. 16. Diffuse axonal injury (DAI) Clinical signs: ↓ LOC ↑ ICP Decerebration or decortication Global cerebral edema
  17. 17. Epidural hematoma Results from bleeding between the dura and the inner surface of the skull A neurologic emergency Venous or arterial origin
  18. 18. Subdural hematoma Occurs from bleeding between the dura mater and arachnoid layer of the meningeal covering of the brain
  19. 19. Fig. 55-15 Subdural Hematoma Epidural Hematoma
  20. 20. Subdural hematoma Usually venous in origin Much slower to develop into a mass large enough to produce symptoms May be caused by an arterial hemorrhage
  21. 21. Subdural hematoma Acute subdural hematoma High mortality Signs within 48 hours of the injury Associated with major trauma (Shearing Forces) Patient appears drowsy and confused Pupils dilate and become fixed
  22. 22. Subdural hematoma Subacute subdural hematoma Occurs within 2-14 days of the injury Failure to regain consciousness may be an indicator
  23. 23. Subdural hematoma Chronic subdural hematoma Develops over weeks or months after a seemingly minor head injury
  24. 24. CT scan considered the best diagnostic test to determine craniocerebral trauma MRI Cervical spine x-ray Glasgow Coma Scale (GCS) Craniotomy Craniectomy Cranioplasty Burr-hole
  25. 25. Nursing Assessment GCS score Neurologic status Presence of CSF leak
  26. 26. Nursing Diagnoses Ineffective tissue perfusion Hyperthermia Acute pain Anxiety Impaired physical mobility
  27. 27. Planning Overall goals: Maintain adequate cerebral perfusion Remain normothermic Be free from pain, discomfort, and infection Attain maximal cognitive, motor, and sensory function
  28. 28. Nursing implementation Health Promotion Prevent car and motorcycle accidents Wear safety helmets
  29. 29. Acute Intervention Maintain cerebral perfusion and prevent secondary cerebral ischemia Monitor for changes in neurologic status
  30. 30. Ambulatory and Home Care Nutrition Bowel and bladder management Spasticity Dysphagia Seizure disorders Family participation and education
  31. 31. Expected Outcomes Maintain normal cerebral perfusion pressure Achieve maximal cognitive, motor, and sensory function Experience no infection, hyperthermia, or pain
  32. 32.  McCaffrey RJ (1997). "Special Issues in the Evaluation of Mild  Traumatic Brain Injury". The Practice of Forensic Neuropsychology: Meeting Challenges in the Courtroom. New  York: Plenum Press. pp. 71–75. ISBN 0-306-45256-1. Jump up^ "What is Head Trauma?". News Medical.  Retrieved 2013-05-04. ^ Jump up to:a  b  "Head injury- first aid". MedlinePlus.  Retrieved 2013-05-04. Jump up^ "Head Injury (Brain Injury)". eMedicinehealth.  Retrieved 2013-05-04. Jump up^ name="Head Injury (Brain Injury)" Jump up^ Carlson, Neil R. (2013). "Physiology of Behavior". In  Campanella, Craig.Neurological Disorders. Pearson Education,  Inc. pp. 526–527. ISBN 0-205-23939-0.

×