Brain and Head Injury is any trauma or injury occurring to the scalp, skull or brain
Scalp Lacerations defined as an external head trauma
Associated with profuse bleeding due to the many blood vessels and poor constrictive abilities
Complications - blood loss and infection
Skull Fractures
Linear fractures are a break without alteration of relationship of parts
Depressed fracture is defined as an inward indentation of the skull
Commonly caused by low-velocity injury
Commonly caused by a powerful blow
Simple fracture can be either linear or depressed without fragmentation or communicating lacerations
Caused by low to moderate impact
Comminuted fractures are multiple linear fractures causing fragmentation of the bones into many pieces
Caused by direct high momentum impact
Compound skull fracture is a depressed fracture of the skull and scalp laceration
Caused by a severe head injury
Symptoms of Skull Fractures - determined by the location and severity and normally develop over several hours
Frontal Fractures symptoms include air in the sinus, forehead tissue or between the cranium and dura matter
Orbital Fractures symptoms include raccoon eyes and optic nerve injury
Temporal Fractures symptoms may include oval-shaped bruises behind ears and epidural haematoma
Prietal Fracture symptoms include deafness, bulging of the tympanic membrane, facial paralysis, battle sign or loss of taste
Posterior Fossa Fracture symptoms include occipital bruising, visual defects or ataxia
Basilar Skull Fractures symptoms include vertigo, facial paralysis and hearing difficulty
Complications of skull fractures are intracranial infections, haematoma, meningeal and brain tissue damage
Head Trauma/Brain Injury Categories
Focal Injury such as a contusion or haematoma can be defined as localised brain damage to a specific area
Diffuse Injuries such as a concussion and diffuse axonal injury can be defined as damage to the brain that cannot be localised to one area
A concussion is a sudden transient mechanical head injury resulting in disrupted neuronal activity and a change in LOC
Signs and symptoms of a concussion include a brief change in LOC, amnesia around event and headache and normally last only for a short time
Complications of concussion include post-concussion syndrome normally developing between two weeks or two months after the initial event. Symptoms include persistent headache, lethargy, personality or behavioural changes, poor attention span and decreased ability to perform ADL's
Diffuse Axonal injury can be defied as widespread axonal damage occurring after a traumatic brain injury
Signs and symptoms may include decreased LOC, increased intracranial pressure and cerebral oedema
Lacerations can be defined as tearing of brain tissue and medical management includes antibiotic treatment
Contusion can be defined as bruising of the brain tissue within a focal area normally associated with a closed head injury.
Complications of a contusion include seizures normally within the first seven days following injury.
Medical Management includes anticoagulant therapy and reducing the risk of falls
Complications of head injury or trauma
Epidural Haematoma occurs as a result of bleeding between the dura and inner surfaces of the skull and is a neurological emergency
Signs and symptoms include initial period of unconsciousness, decreased LOC, headache, nausea, vomiting
Subdural Haematoma occurs as a result of bleeding between the dura matter and arachnoid layer of the meninges usually as a result of brain tissue and blood vessel damage
Signs and symptoms include increased ICP, decreased LOC and headache and the size determines patient presentation which is commonly drowsy, confused or unconscious.
Intracerebral Haematoma is defined as bleeding within brain tissue usually within the frontal and temporal lobes from rupture of vessels at the time of an injury