Description i. Definition= includes any injury/trauma to scalp, skull, or brain. A serious form of head injury is traumatic brain injury. ii. Immediate complications= Death can occur immediately after the injury, within 2 hours after injury, and approximately 3 weeks after. Deaths occurring immediately after the injury occur from massive hemorrhage and shock. Arterial epidural hematomas. iii. Causes = the most common causes are falls and MVAs. Other causes are firearms, assaults, sports-related traumas, recreational injuries, and war-related injuries. Males are twice as likely to sustain a TBI as females. iv. Mechanism of Injury Acceleration= head immobile hit by moving object Deceleration= mobile head hits immobile object Acceleration-Deceleration= immobile head hit by a mobile object causing it to hit immobile object Penetrating= skull integrity lost Coup-countercoup= injury occurs at site of blow causing jarring of the brain against the skull B. Types of Head Injury – Scalp Lacerations o External head trauma o Scalp is highly vascular → Profuse bleeding o Major complications – blood loss and infection Concussion o Diffuse Injury o Concussion (a sudden transient mechanical head injury with disruption of neural activity and a change in the LOC) is considered a minor diffuse head injury. The patient may or may not lose total consciousness with this injury. o Typical signs of concussion include a brief disruption in LOC, amnesia regarding the event (retrograde amnesia), and headache. The manifestations are generally of short duration. o If the patient has not lost consciousness, or if the loss of consciousness lasts less than 5 minutes, the patient is usually discharged from the care facility with instructions to notify the HCP if symptoms persist or if behavioral changes are noted. Post-concussion syndrome • may develop in some patients and is usually seen anywhere from 2 weeks to 2 months after the injury. • Manifestations include persistent headache, lethargy, personality and behavioral changes, shortened attention span, decreased short-term memory, and changes in intellectual ability. • This syndrome can significantly affect the patient’s abilities to perform activities of daily living.
• Although concussion is generally considered benign and usually resolves spontaneously, the signs and symptoms may be the beginning of a more serious, progressive problem, especially in a patient with a history of prior concussion or head injury. At the time of discharge, it is important to give the patient and caregiver instructions for observation and accurate reporting of symptoms or changes in neurologic status. -Skull fractures (Types Table 56-6) • There are several ways to describe skull fractures: (1) linear or depressed; (2) simple, comminuted, or compound; and (3) closed or open.
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- Spring '16
- Traumatic brain injury