Head Injury Flashcards

1
Q

What is the difference between primary + secondary brain injury due to head injury?

A

Primary: occurs at time of injury
Secondary: occurs due to consequence of injury

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2
Q

What is the normal range for adult intracranial pressure?

A

9-11 mm Hg

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3
Q

What does a patient with an anterior cranial fossa fracture look like? (buzzword)

A

Racoon/panda eyes

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4
Q

What does a patient with a middle cranial fossa fracture look like? (buzzword)

A

Battle sign bruising over mastoid area

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5
Q

No pupillary response to light suggest which cranial nerve palsy?

A

CN III

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6
Q

Brain herniation can result due to raised intracranial pressure. Describe a subfalcine herniation

A

Cingulate gyrus pushed under falx cerebri

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7
Q

Which structures are particularly at risk in a subfalcine herniation?

A

Anterior cerebral arteries

Paramedian cortex

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8
Q

Brain herniation can result due to raised intracranial pressure. Describe a transtentorial herniation

A

Medial temporal lobe squeezed under tentorium

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9
Q

Which structures are particularly at risk in a transtentorial herniation?

A

CN III
Posterior cerebral artery
Cerebral peduncle
Upper brainstem (later)

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10
Q

Brain herniation can result due to raised intracranial pressure. Describe a tonsillar herniation

A

Cerebellar tonsils forced through foramen magnum

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11
Q

Which structures are particularly at risk in a tonsillar herniation?

A

Brainstem

CSF outflow

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12
Q

A coma equates to what score on the Glasgow Coma Score?

A

8

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13
Q

When should a CT scan be requested in head trauma?

A
Any one of the following:
Skull fracture
GCS less than 15
Focal neurological signs
Taking warfarin
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14
Q

List intensive care management of head injury

A
Sedation
Ventilation
BP management
Glucose maintenance
Temperature maintenance
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15
Q

How does sedation help in management of head injury?

A

Reduces cerebral metabolic rate, blood flow and ICP

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