Head-Injury 2024 bt assisst prof.dr.amer-ppt.pptx

Head injury is defined as any trauma to the head other than superficial injuries to the face (NICE 2017)

1. Head Injuries Internal Medicine and Surgery for Second Stage/Community Health Department Prepared By Assist. Prof. Dr. Amer Muhssen

2. Definition Head injury is defined as any trauma to the head other than superficial injuries to the face (NICE 2017) Traumatic brain injury (TBI) is a non specific term describing blunt, penetration or blast injuries to the brain. TBI can be classified as mild, moderate or severe, typically based on the GCS Head injuries may be either closed or open. A closed head injury is any injury that doesn’t break your skull. An open (penetrating) head injury is one in which something breaks your scalp and skull and enters your brain.

3. Why important? 1.4 million attendances in EDs England & Wales with head injuries 200,000 admitted to hospitals pa Of these 1 in 5 have skull fracture or evidence brain damage 95% people sustained head injury normal / minimally impaired conscious level (GCS >12) Lower GCS increased morbidity / mortality Although most recover without specialist intervention others experience long-term disability

4. Why Care? Head injury commonest cause of death / disability in people aged 1 – 40 years in UK High potential for poor outcome (especially if not recognised ) Deaths occur at three points in time after injury: Immediately after the injury Within 2 hours after injury 3 weeks after injury

5. Basic Anatomy

6. What causes a head injury ? Head injuries caused by a blow to the head are usually associated with: motor vehicle accidents falls physical assaults sports-related accidents

7. What are the major types of head injuries ? Hematoma Hemorrhage Concussion Edema Skull fracture Diffuse axonal injury

8. Hematoma A hematoma is a collection, or clotting, of blood outside the blood vessels. It can be very serious if a hematoma occurs in the brain. The clotting can lead to pressure building up inside your skull. This can cause you to lose consciousness or result in permanent brain damage.

9. Hemorrhage A hemorrhage is uncontrolled bleeding. There can be bleeding in the space around your brain, called subarachnoid hemorrhage, or bleeding within your brain tissue, called intracerebral hemorrhage. Subarachnoid hemorrhages often cause headaches and vomiting. The severity of intracerebral hemorrhages depends on how much bleeding there is, but over time any amount of blood can cause pressure buildup.

10. Concussion A concussion occurs when the impact on the head is severe enough to cause brain injury. It’s thought to be the result of the brain hitting against the hard walls of your skull or the forces of sudden acceleration and deceleration. Generally speaking, the loss of function associated with a concussion is temporary. However, repeated concussions can eventually lead to permanent damage.

11. Edema Any brain injury can lead to edema, or swelling. Many injuries cause swelling of the surrounding tissues, but it’s more serious when it occurs in your brain. Your skull can’t stretch to accommodate the swelling. This leads to pressure buildup in your brain, causing your brain to press against your skull.

12. Skull fracture Unlike most bones in your body, your skull doesn’t have bone marrow. This makes the skull very strong and difficult to break. A broken skull is unable to absorb the impact of a blow, making it more likely that there’ll also be damage to your brain.

13. Diffuse axonal injury A diffuse axonal injury (sheer injury) is an injury to the brain that doesn’t cause bleeding but does damage the brain cells. The damage to the brain cells results in them not being able to function. It can also result in swelling, causing more damage. Though it isn’t as outwardly visible as other forms of brain injury, a diffuse axonal injury is one of the most dangerous types of head injuries.

14. What are the symptoms of a head injury ? Common symptoms of a minor head injury include: a headache lightheadedness a spinning sensation mild confusion nausea temporary ringing in the ears

15. When does a head injury require medical attention ? In particular, you should always seek immediate medical attention if you experience any of the following: loss of consciousness confusion disorientation

16. Diagnosis test for head injury clinical feature physical examination laboratory study e.g. blood test head X-ray CT –SCAN MRI Glasgow Coma Scale (GCS). The GCS is a 15-point test that assesses your mental status. A high GCS score indicates a less severe injury.

17. C. Surgery : Emergency surgery may be needed to minimize additional damage to brain tissues. Surgery may be used to address the following problems 1. Removing clotted blood (hematomas). Bleeding outside or within the brain can result in a collection of clotted blood (hematoma) that puts pressure on the brain and damages brain tissue? 2. Repairing skull fractures. Surgery may be needed to repair severe skull fractures or to remove pieces of skull in the brain. 3. Opening a window in the skull. Surgery may be used to relieve pressure inside the skull by draining accumulated cerebral spinal fluid or creating a window in the skull that provides more room for swollen tissues.

18. How is a head injury treated ? The treatment for severe head injuries can include : Medication Surgery Rehabilitation

19. Management of head injuries Medicine treatment 1. Mild injury Mild traumatic head injuries usually require no treatment other than rest and over-the-counter pain relievers to treat a headache. A person with a mild traumatic head injury usually needs to be monitored closely at home for any persistent, worsening or new symptoms.

20. 2. Immediate Emergency care:- for moderate to severe traumatic head injuries focuses on making sure the person has an adequate oxygen and blood supply, maintaining blood pressure, and preventing any further injury to neck. People with severe injuries may also have other injuries that need to be addressed

21. B . Medications: use medications to limit secondary damage to the brain immediately after an injury may include: Diuretics. These drugs reduce the amount of fluid in tissues and increase urine output. Diuretics, given intravenously to people with traumatic brain injury, help reduce pressure inside the brain. Anti-seizure drugs. People who've had a moderate to severe traumatic brain injury are at risk of having seizures during the first week after their injury. An anti-seizure drug may be given during the first week to avoid any additional brain damage that might be caused by a seizure. Additional anti-seizure treatments are used only if seizures occur.

22. . Coma-inducing drugs. Use drugs to put people into temporary comas because a comatose brain needs less oxygen to function. This is especially helpful if blood vessels, compressed by increased pressure in the brain, are unable to deliver the usual amount of nutrients and oxygen to brain cells.

23. C. Surgery : Emergency surgery may be needed to minimize additional damage to brain tissues. Surgery may be used to address the following problems 1. Removing clotted blood (hematomas). Bleeding outside or within the brain can result in a collection of clotted blood (hematoma) that puts pressure on the brain and damages brain tissue? 2. Repairing skull fractures. Surgery may be needed to repair severe skull fractures or to remove pieces of skull in the brain. 3. Opening a window in the skull. Surgery may be used to relieve pressure inside the skull by draining accumulated cerebral spinal fluid or creating a window in the skull that provides more room for swollen tissues.

24. Thanks for Listening