Head and Brain Injuries Overview

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Questions and Answers

What distinguishes an open head injury from a closed head injury?

  • An open head injury compromises the integrity of the skull. (correct)
  • A closed head injury involves penetration of the skull.
  • An open head injury is always severe.
  • A closed head injury only results from accidents.

Which type of brain injury is characterized by no identified brain damage despite a change in neurological function?

  • Contusion
  • Diffuse axonal injury
  • Intracranial hemorrhage
  • Concussion (correct)

What type of brain injury typically leads to coma and is observed in severe head trauma?

  • Contusion
  • Concussion
  • Diffuse axonal injury (correct)
  • Intracranial hemorrhage

What is a common complication of open-head injuries?

<p>High risk for infection (C)</p> Signup and view all the answers

After a head injury, what could drainage from the ears or eyes indicate?

<p>Potential cerebral spinal fluid leakage (A)</p> Signup and view all the answers

Which type of hematoma can present with delayed symptoms, occurring weeks to months after injury?

<p>Subacute or chronic subdural hematoma (C)</p> Signup and view all the answers

What physical manifestation might occur at the site of a skull fracture?

<p>Localized pain and swelling (D)</p> Signup and view all the answers

In the context of head injuries, when should a cervical spine injury be suspected?

<p>Immediately after any head injury occurs (C)</p> Signup and view all the answers

What is a major cause of neurologic injury in adults aged 65 to 75?

<p>Falls (D)</p> Signup and view all the answers

What is the recommended action for firearm owners to prevent accidents?

<p>Lock all firearms (B)</p> Signup and view all the answers

Which of the following is a manifestation of increased intracranial pressure?

<p>Dilated or pinpoint nonreactive pupils (C)</p> Signup and view all the answers

What might indicate a basilar skull fracture after a head injury?

<p>CSF leakage from the nose or ears (A)</p> Signup and view all the answers

What is a recommended safety measure when riding in a vehicle?

<p>Alwayswear a seatbelt (A)</p> Signup and view all the answers

What risk factor is associated with gunshot wounds?

<p>Assault (C)</p> Signup and view all the answers

Which of the following is NOT a sign of increased intracranial pressure?

<p>Calm demeanor (C)</p> Signup and view all the answers

What should be assessed if a patient experiences a loss of consciousness after a head injury?

<p>Duration of unconsciousness (C)</p> Signup and view all the answers

What is a common risk associated with older adults sustaining head injuries?

<p>Higher adherence of dura mater to the skull (D)</p> Signup and view all the answers

What is the 'halo sign' indicative of?

<p>CSF leakage (C)</p> Signup and view all the answers

What is the primary reason for maintaining cervical spine stability in a patient with a head injury?

<p>To prevent further neurological damage (B)</p> Signup and view all the answers

Which measure should be implemented to prevent complications of immobility in head-injured patients?

<p>Turn the patient every 2 hours to prevent pressure sores (A)</p> Signup and view all the answers

What precaution should be taken if cerebrospinal fluid (CSF) is noted from the patient's nose or ears?

<p>Report the presence of CSF to the provider (B)</p> Signup and view all the answers

How can families cope effectively following a head injury of a loved one?

<p>By seeking information and support from community resources (B)</p> Signup and view all the answers

What important aspect should be monitored in patients with head injuries who are receiving IV fluids?

<p>Excess fluid volume to prevent increased intracranial pressure (D)</p> Signup and view all the answers

Flashcards

Open Head Injury

Damage to the skull, causing a break in integrity, often from a penetrating object or blunt force.

Closed Head Injury

Head injury from blunt force, causing acceleration/deceleration or impact against a fixed object.

Concussion

Mild traumatic brain injury; temporary change in brain function after head trauma, no lasting damage.

Contusion

Bruising of the brain, often causing unconsciousness, stupor, or confusion.

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Diffuse Axonal Injury

Widespread brain damage, often leading to coma, associated with severe head trauma.

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Intracranial Hemorrhage

Collection of blood within the brain following head trauma.

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Glasgow Coma Scale

Rating system used to assess the severity of head injuries based on neurological function

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Cervical Spine Injury

Injury to the neck region's vertebrae, always a concern with head trauma and must be ruled out before any interventions.

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Head Injury Prevention: Sports

Wearing helmets during activities like skateboarding, cycling, skiing, and sports like football reduces the risk of head injuries.

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Head Injury Prevention: Driving

Buckling up in vehicles and avoiding dangerous driving behaviors like speeding and driving under the influence helps prevent head injuries.

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Head Injury Prevention: Firearms

Storing firearms safely, like locking them up, minimizes the risk of accidental head injuries.

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Head Injury Prevention: Older Adults

Programs focused on fall prevention are crucial for older adults, as falls are a major cause of neurological injuries in this age group.

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Head Injury Risk Factors

Common factors contributing to head injuries include motor vehicle crashes, substance abuse, sports injuries, assaults, gunshot wounds, and falls.

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Head Injury Assessment: Amnesia

Memory loss before or after a head injury, known as amnesia, is a significant indicator.

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Head Injury Assessment: Loss of Consciousness

The duration of unconsciousness following a head injury plays a crucial role in assessing severity.

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Head Injury Assessment: CSF Leakage

Fluid leaking from the nose or ears might indicate a basilar skull fracture, a serious head injury.

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Head Injury Assessment: Increased Intracranial Pressure

High pressure within the skull can manifest as severe headache, nausea, vomiting, altered consciousness, dilated pupils, and breathing difficulties.

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Head Injury Assessment: Cushing's Triad

A late and serious sign of increased intracranial pressure characterized by high blood pressure, a widening pulse pressure, and slow heart rate.

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Family Support after Head Injury

Families of head injury patients need support from healthcare providers and communities to cope with the emotional and practical challenges.

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Brain Death and Organ Donation

When a brain injury results in brain death, the family must decide whether to donate organs, a sensitive and challenging decision.

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Cervical Spine Stability

Maintaining stability of the neck is crucial after a head injury, as it helps prevent potential spinal cord damage.

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CSF Leakage: Sign of Serious Injury

Fluid leaking from the nose or ears could indicate a basilar skull fracture, a serious head injury.

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Fluid Management After Head Injury

Maintaining adequate fluids is crucial for cerebral perfusion and minimizing edema, but monitoring for fluid overload is essential.

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Study Notes

Head Injuries

  • Head injuries are categorized as open or closed.
  • Open head injuries involve a compromised skull, either due to penetration or blunt force trauma.
  • Closed head injuries result from blunt trauma causing head acceleration and deceleration, or striking a stationary object.
  • Head injuries are further classified as mild, moderate, or severe, based on Glasgow Coma Scale ratings and loss of consciousness duration.

Types of Brain Injury

  • Brain injury types include concussion, contusion, diffuse axonal injury, and intracranial hemorrhage.
  • Concussion (mild traumatic brain injury): Results from head trauma causing a change in neurological function but no visible brain damage; usually resolves within 72 hours. Post-concussion syndrome can last longer, with persistent cognitive & physical symptoms for an unspecified time.
  • Contusion: A brain bruise, often associated with periods of unconsciousness, stupor, or confusion.
  • Diffuse axonal injury: Widespread brain damage, leading to coma, typically seen in severe head trauma.
  • Intracranial hemorrhage: Blood pooling within the epidural, subdural, or intracerebral spaces after head trauma. Subacute or chronic subdural hematomas may show symptoms delayed by weeks or months.

Open Head Injuries

  • Open head injuries increase risk of infection.
  • Scalp injuries frequently result in heavy bleeding due to impaired blood vessel constriction.

Skull Fractures

  • Skull fractures can happen because of forceful head injuries and might cause brain damage.
  • Patients may experience localized pain at the fracture site.
  • Swelling might be present.
  • Nurses should monitor for drainage from ears or eyes (cerebrospinal fluid – CSF).

Cervical Spine Injury

  • Cervical spine injury is a potential concern whenever a head injury occurs.
  • Before any devices securing the cervical spine are removed, a cervical spine injury must be ruled out.

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