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HEAD TRAUMA
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Neurologic AssessmentNeurologic Assessment
Levels of consciousness
Glassgow coma scale
Cranial nerve assessment
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Definition Traumatic Brain Injury (TBI)
is a result of an external mechanical
force to the brain that leads in a change to
cognitive, physical, psychosocialfunctioning associated with
altered state of consciousness.
The impairments can be temporary or permanent
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Risks Factor
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Risks Factor
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Firearms
Risks Factor
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Primary Brain Injury
Results from what has
occurred to the brain at
the time of the injury
Traumatic Brain InjurySecondary Brain Injury
Physiologic and
biochemical events
which follow the
primary injury
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Categories of Brain InjuriesClosed (Blunt) Brain Injury
Acceleration/Deceleration
If a moving object hits a
movable head (e.g. head
gets hit with a bat)
If a moving head hits
something stationary
Shaken type of
movement
(e.g. when head rocks
back and forth in skull).
Non-Acceleration
Much more rare,
referred to as a
crushing injury
If a moving object hits a
head that is fixed (e.g.
car falls on head while
youre working under it).
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Low Velocity
Skull is no longer intact,
part of skull or debris
gets into the brain.
High Velocity
Bullets penetrate the
skull and goes into the
brain matter.
Categories of Brain InjuriesOpen Brain Injury
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CAUSES OF BRAINCAUSES OF BRAIN INJURIESINJURIESCAUSES OF
BRAINCAUSES OF BRAIN INJURIESINJURIESCoup and Countercoup
InjuriesConcussion vs Contusion
Diffuse Axonal InjuryEpidural HematomaSubdural
HematomaIntracerebral Hemorrhage
Compound fracturePenetrating injury
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The energy of impact from a small
hard object tends to dissipate at theimpact site, leading to a
COUP
contusion
Impact from a larger object
causes less injury at the impact
site, since the energy is dissipated
at the beginning or end of the
head motion.
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ContusionContusionBruising type of injury to the brain resulting
to
sudden loss of consciousness or coma.
Contusion may occur with subdural/extradural collection of
blood, intracerebralhemorrhage.
Contusion is considered severe form ofaxonal injury with
shearing of blood.
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ConcussionConcussionMild bruising to the cerebral tissue cause
by
jarring of the brain resulting in transient
loss of consciousness.
Concussion is considered a mild form of
diffuse axonal injury
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Categories ofD
iffuse Brain Injury
5
Mild Concussion (without LOC)
Grade I confusion disorientation with amnesia
Grade II confusion and retrograde amnesia (5-10 min)Grade III
confusion with retrograde and anterograde.
Immediate but transitory clinical manifestation.
CSF pressure rises, ECG, EEG changes.
Confusion last for several minutes. with amnesia for events
preceding the trauma.
head pain, nervousness and not being themselves.
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DiffuseDiffuse Axonal InjuryAxonal InjuryDiffuse axonal injury
is characterized by
extensive generalized damage to the whitematter of the brain
Strains during high-speed
acceleration/deceleration produced in lateralmotions of the head
may cause the injury.
