Head,brain and spinal injury

1. NEUROLOGICAL TRAUMA
Submitted to- Submitte by-
Ma’am Jisa Shreya Yadav
Principal nursing tutor
School of nursing school of
nursing
St catherine st catherine
hospital hospital

2. Neurological trauma-
1. Head injury
2. Brain injury
3. Spinal injury
 Head injury- Any insult to the brain
i.e, capable of producing physical,
intellectual, emotional and vocational
changes.

3. Etiology and risk factor-
Motor accident
Alcoholism
Driving without seat belt
Spot related injury i.e, Assault falls.

4. Types of head injury-
a. Scalp head injury- It can cause
laserartion resulting in bleeding.
b. Skull injuries or fracture- It is often
caused by a force sufficient to fracture
scalp and cause brain injury.
It is again devided into 3 types-
 Linear skull injury
 Depressed skull fracture
 Basilar skull fracture

5. Linear skull injury- A linear skull
fracture is a break in a cranial bone
resembling a thin line,without
splinting,depression.
Depressed skull fracture- is a
breakdown in a cranial bone with
depression of the bone in toward the
brain.

6. Basilar skull fracture- is a break of a
bone in the base of the skull symptoms
may include bruising behind the ear,
bruising around the eye or blood behind
the ear drum.

7. Brain injury- is defined as penetrating
head injury that distrupt the normal
function of the brain.
It is devided into-
Cocussion- Head trauma that may
result in loss of consciousness for 5 min.
or less and retrograde amensia.There is
no break down in skull and damage.

8. Contussion- it is more extensive damage
then concussion with contussion the
brain itself is damage often with multiple
areas of small hemorrhage or bruised area
in brain tissue.
Diffuse axonal injury- it is most severe
form of head injury involves the brain and
tissues of the entire brain.

9. Diffuse axonal injury is divided into –
MILD(6-24 hr)
MODERATE(less than 24 hr)
SEVERE(pt will be in coma)
Clinical manifestation-
Unconsciousness,pupil diltation
Subdural hematoma
Tearing of bridge over the brain.
Inability to speak

10. Mental confusion
Dizziness
Fainting
Stiff muscles
Nausea vomiting
Slurred speech
Blurred vision

11. Diagnostic evaluation-
History collection and physical
examination.
Neurological assessment
CT-scan
Magnetic resonance imagine
Positron emmission tomography
X-ray

12. Management-
 Severe head injury is best managed in a
neuro intensive care setting.
 The patient should be positioned with
the head up 30 degree.
 It is important to ensure that the
cervical immobolisation.
 Initial management
(circulation,airway,breathing).

13.  Medical management-
Osmotic diuretic(mannitol 25%)
Anticoagulants(phenytoin)
Bariturates(rentobarbitural –decrease
ICP).
Surgical management-
Cranioplasty(repair or a defect or
deformity of a skull)
Craniectomy(excission into the
cranium to cut deformity of a skull)

14. Nursing management-
Manitain Circulation airway, breathing
Monitor glassgow coma scale.
Assess neurological assessment.
Assess vital sign properly
Check for increased ICP pressure.

15. Spinal cord injury- it is damage to the
spinal cord that results in a loss of
function as mobility or feeling.
Types of spinal cord injury-
Complete spinal cord injury- a
complete spinal cord injury removes
the brain’s ability to send signals down
the spinal cord below the site of the
injury.

16. Incomplete spinal cord injury- a spinal
cord injury damage to any part of the
spinal cord below the affected area.
Causes-
Traumatic
Electric shock
Bullet or stab wound
Extreme twisting of the middle of the
body.
Fall from great height.

17. Diagnostic test-
History collection and physical
examination.
ATRIAL BLOOD Gas level
CT- scan
MRI
X-RAY to rule out lumbosacral and
cervical area to identify deformities.

18. Management-
Corticosteroid(hydrocortisone)
Norepinephrine
Epineohrine
Dopamine
Immobolize neck to prevent further
spinal cord injury.
Avoid possible complication such as
stool or urine retention,respiratory or
cardiovascular defficulty.

19. Nursing management-
Assess the vital sign properly.
Maintain circulation airway breathing.
Assess neurological status.
Always provide safety measures.