Neuro Head Injury PDF

NEURO Head Injury Cerebral Aneurysm Ch 38 & 41 ANATOMY & PHYSIOLOGY CRANIAL PROTECTION 1. 48% Falls – think old people 1. Can be a minimal level fall that cause great damage 2. 14% Motor Vehicle Crashes (MVC) 3. 15% Struck by object 4. 10% Assaults COMMON TBI CAUSES SI...

NEURO Head Injury Cerebral Aneurysm Ch 38 & 41 ANATOMY & PHYSIOLOGY CRANIAL PROTECTION 1. 48% Falls – think old people 1. Can be a minimal level fall that cause great damage 2. 14% Motor Vehicle Crashes (MVC) 3. 15% Struck by object 4. 10% Assaults COMMON TBI CAUSES SIGNS OF A BASILAR SKULL FX MONROE-KELLIE HYPOTHESIS OF ICP Increased ICP p913 FOCAL BRAIN INJURIES Intracranial hemorrhages  Level of consciousness  Glasgow coma scale (GCS) 3-15  Eye & verbal response scale (gives a good QUANTITATIVE #)  Respiration pattern  Cheyne-Stokes (crescendo & apnea)  Hyperventilation (all breaths are deep w/a lot of depth – blowing off too much CO2/)  Ataxic/agonal “gucky” (no pattern – having to count respirations for a full minute)  Pupillary Function and Eye Movement  Doll’s eyes- fixed to one side  Oculovestibular reflex- touch cornea = blink  Babinski reflex – NO toe spreading  Posturing PHYSICAL ASSESSMENT normal abnormal  Eye opening  Best verbal  Best motor GLASCOW COMA SCALE (GCS) PHYSICAL EXAMINATION (CONTINUED) PHYSICAL EXAMINATION (CONTINUED) P833 Decorticate Decerebrate  ↑ ICP impairs cerebral perfusion and oxygenation  Normal value (5-10mmHg)  Disorders that ↑ these components  Brain (cerebral edema, hematomas, tumors)  CSF (hydrocephalus, subarachnoid hemorrhage, meningitis)  Blood (hypercapnia, hypoxia)  Normal-coughing, sneezing, positioning, noxious stimuli-loud noises, visual  Abnormal- hypoxia, suctioning, increased pCO2, positioning, edema Quiet environment – decrease stimuli Elevate HOB Blood Pressure Control SBP