This document discusses neurological trauma, including head injury, brain injury, and spinal injury. Head injuries can be scalp injuries, skull fractures (linear, depressed, or basilar), concussions, or contusions. Brain injuries include diffuse axonal injury (mild, moderate, or severe). Spinal cord injuries can be complete or incomplete. Management of neurological trauma involves initial stabilization, diagnostic testing, medical management (e.g. mannitol, phenytoin), surgical management (e.g. cranioplasty, craniectomy), and focused nursing care (e.g. monitoring, positioning, assessing neurological status).

1. NEUROLOGICAL TRAUMA
Submitted to- Submitte by-
Ma’am Jisa Shreya Yadav
Principal nursing tutor
School of nursing school of
nursing
St catherine st catherine
hospital hospital

2. Neurological trauma-
1. Head injury
2. Brain injury
3. Spinal injury
 Head injury- Any insult to the brain
i.e, capable of producing physical,
intellectual, emotional and vocational
changes.

3. Etiology and risk factor-
Motor accident
Alcoholism
Driving without seat belt
Spot related injury i.e, Assault falls.

4. Types of head injury-
a. Scalp head injury- It can cause
laserartion resulting in bleeding.
b. Skull injuries or fracture- It is often
caused by a force sufficient to fracture
scalp and cause brain injury.
It is again devided into 3 types-
 Linear skull injury
 Depressed skull fracture
 Basilar skull fracture

5. Linear skull injury- A linear skull
fracture is a break in a cranial bone
resembling a thin line,without
splinting,depression.
Depressed skull fracture- is a
breakdown in a cranial bone with
depression of the bone in toward the
brain.

6. Basilar skull fracture- is a break of a
bone in the base of the skull symptoms
may include bruising behind the ear,
bruising around the eye or blood behind
the ear drum.

7. Brain injury- is defined as penetrating
head injury that distrupt the normal
function of the brain.
It is devided into-
Cocussion- Head trauma that may
result in loss of consciousness for 5 min.
or less and retrograde amensia.There is
no break down in skull and damage.

8. Contussion- it is more extensive damage
then concussion with contussion the
brain itself is damage often with multiple
areas of small hemorrhage or bruised area
in brain tissue.
Diffuse axonal injury- it is most severe
form of head injury involves the brain and
tissues of the entire brain.

9. Diffuse axonal injury is divided into –
MILD(6-24 hr)
MODERATE(less than 24 hr)
SEVERE(pt will be in coma)
Clinical manifestation-
Unconsciousness,pupil diltation
Subdural hematoma
Tearing of bridge over the brain.
Inability to speak

10. Mental confusion
Dizziness
Fainting
Stiff muscles
Nausea vomiting
Slurred speech
Blurred vision

11. Diagnostic evaluation-
History collection and physical
examination.
Neurological assessment
CT-scan
Magnetic resonance imagine
Positron emmission tomography
X-ray

12. Management-
 Severe head injury is best managed in a
neuro intensive care setting.
 The patient should be positioned with
the head up 30 degree.
 It is important to ensure that the
cervical immobolisation.
 Initial management
(circulation,airway,breathing).

13.  Medical management-
Osmotic diuretic(mannitol 25%)
Anticoagulants(phenytoin)
Bariturates(rentobarbitural –decrease
ICP).
Surgical management-
Cranioplasty(repair or a defect or
deformity of a skull)
Craniectomy(excission into the
cranium to cut deformity of a skull)

14. Nursing management-
Manitain Circulation airway, breathing
Monitor glassgow coma scale.
Assess neurological assessment.
Assess vital sign properly
Check for increased ICP pressure.

15. Spinal cord injury- it is damage to the
spinal cord that results in a loss of
function as mobility or feeling.
Types of spinal cord injury-
Complete spinal cord injury- a
complete spinal cord injury removes
the brain’s ability to send signals down
the spinal cord below the site of the
injury.

16. Incomplete spinal cord injury- a spinal
cord injury damage to any part of the
spinal cord below the affected area.
Causes-
Traumatic
Electric shock
Bullet or stab wound
Extreme twisting of the middle of the
body.
Fall from great height.

17. Diagnostic test-
History collection and physical
examination.
ATRIAL BLOOD Gas level
CT- scan
MRI
X-RAY to rule out lumbosacral and
cervical area to identify deformities.

18. Management-
Corticosteroid(hydrocortisone)
Norepinephrine
Epineohrine
Dopamine
Immobolize neck to prevent further
spinal cord injury.
Avoid possible complication such as
stool or urine retention,respiratory or
cardiovascular defficulty.

19. Nursing management-
Assess the vital sign properly.
Maintain circulation airway breathing.
Assess neurological status.
Always provide safety measures.