HEAD INJURY- Basic Neurology and Assessment.pptx

Any injury to the head region or cranio-cerebral region, impacting the brain and tissues within is termed as Head Injury or Traumatic Brain Injury (TBI)
Often leads to permanent disability or death.
Physical and neuropsychological disabilities are frequent in moderate and mild injuries
Often accompa...

Any injury to the head region or cranio-cerebral region, impacting the brain and tissues within is termed as Head Injury or Traumatic Brain Injury (TBI)
Often leads to permanent disability or death.
Physical and neuropsychological disabilities are frequent in moderate and mild injuries
Often accompanied by spinal injuries
Intoxication is an important aspect to check in such cases
Care should be taken not to compress the spinal cord during first aid and treatment.
Main clinical manifestations include impaired consciousness, memory deficits accompanied by neurological deficits and epileptic seizures.
Causes: Blunt Injuries like Motor vehicle accidents, falls
Gunshot wounds accounting for 35% deaths
Vascular injury resulting from any traumatic brain accident with or without penetrating trauma
Development of SAH and SDH
Blast injuries usually in cases of military conflicts
Concussion injury especially in sports athletes.
Focal skull injuries like depressed linear and basal skull fractures
Mechanism: Most commonly affected by blunt injuries including low impact and high impact forces, that can be direct blows or motor vehicle collisions.
Sudden implication of physical force which changes the magnitude of movement of the head with respect to the body.
Generally, without injury to the head brain suffers no injury except for cases of whiplash injuries and injuries where there is abrupt changes within the pressure of cranium
Mechanical factors include differential mobility of head with respect to neck and cranium
Crushing injuries to the brain or skull
Haemorrhage or destruction of brain tissue
Classification: Injuries on the basis of mechanism, severity and structural probability can be overviewed as following.
Based on the structural integrity, TBI can be broadly classified as open or closed head injuries
Based on mechanism of injury, TBI can be classified as blunt, penetrating or blast injuries
Based on severity, which is calculated using the Glasgow Coma Scale, there are three types of head injuries: mild, moderate and severe.
Open Injuries: Open injuries are those in which wounds are extended into the subdural compartment or deeper to the brain tissues and neurons.
Generally accompanied with leakage of Cerebrospinal fluid.
Carry risk of infections (early or late induced) such as meningitis, brain abscess, etc.
Closed Injuries: Closed head injuries are those where there is trauma to the brain but the duramater remains intact and there is no penetration or de-arrangement within the brain tissues and cells.
Usually in skull fractures where duramater remains intact.
Do not accompany any risk to leakage of CSF
Focal Brain Injuries: Focal lesions of the brain can be coup or counter-coup injuries.
Extra-dural hematoma results from skull fractures with stripping of dura from the skull
Hematoma forms a lens shape in which blood fills and causes further stripping of the duramater within the skull.
Clinical deteriorations are rapid in such conditions.