1) The document presents a case study on head injury, discussing the patient's presentation, assessments, investigations showing hemorrhaging in the brain, and treatment plan. 2) Head injuries can cause brain damage even if seemingly minor due to reduced blood flow and oxygen, and the brain cannot restore these easily. Complications can include altered consciousness, seizures, infections and intellectual or behavioral issues. 3) Prognosis depends on individual factors like additional injuries, age, prior head traumas, stress levels, and support systems. Management involves treatments to reduce swelling, seizures, and complications along with addressing nursing needs like monitoring for increased pressure and skin integrity issues.

1. MEDICAL SURGICAL
NURSING -II
CASE PRESENTATION
ON
HEAD INJURY
PRESENTED BY:
AMANDA KHARSAMAI
MSC. NURSING 2ND YR

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.

3. PATIENT INFORMATION
•Chief complaints
•Past history
•Personal history
•Socio-economic status

4. PHYSICAL ASSESSMENT
• General appearance
• Systems assessment
• Glasgow coma scale

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

7. ANATOMY AND
PHYSIOLOGY

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.

12. TYPES

14. ETIOLOGY
•Falls
•Vehicle- related collisions
•Violence
•Sports injuries
•Explosive blasts
•Penetrating wounds
Risk Factors
•Children especially
newborns to 4 yrs
•Young adults especially 15-
24 yrs
•Adults aged 60 and older
•Males in any age group

15. PATHOPHYSIOLOGY

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

18. MANAGEMENT
• Medical
Anti-seizures
Coma inducing drugs
Diuretics
Anti-hypertensives
Corticosteroids
• Surgical
Craniotomy
Endoscopic ventriculostomy
Decompressive craniectomy
Cranioplasty

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.

24. CONCLUSION

25. THANK YOU