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Head Injury Management and Monitoring

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J
Jeku Jacob

Head injuries most commonly occur in individuals aged 15-24 from vehicular accidents or falls in those over 75. The brain is surrounded by meninges including the dura, arachnoid and pia mater. Increased intracranial pressure can decrease cerebral perfusion and cause neurological deterioration, so monitoring and medical or surgical interventions aim to reduce pressure and maintain blood flow to the brain.

Health & Medicine
1 of 44
Head Injury Niamh Bambury Lecturer in Surgery 18/09/08
Introduction ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Anatomy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Scalp ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Structure of the brain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Structure of the brain ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Structure of the brain ,[object Object],[object Object],[object Object],[object Object]
 
Meninges ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Meninges ,[object Object],[object Object],[object Object],[object Object],[object Object]
Blood supply
CSF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurophysiology ,[object Object],[object Object],[object Object],[object Object],[object Object]
Intracranial pressure ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Monroe-Kellie doctrine CSF Brain Blood Compensation occurs up to a value of 100mls. eg. an increase in lesion volume (e.g. extradural hematoma) will be compensated by the downward displacement of CSF and venous blood.
Why is ICP important ,[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of raised ICP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ICP cont’d ,[object Object],[object Object],[object Object],[object Object],[object Object]
Raised ICP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Neurological assessment in A&E ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Disability ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Secondary Survey of the head ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Secondary survey of the head ,[object Object],[object Object],[object Object],[object Object]
Glasgow coma scale
Classification of head injury ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intracranial haemorrhage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contusions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Contusions ,[object Object],[object Object]
Extradural haematoma ,[object Object],[object Object],[object Object]
Extradural haematoma ,[object Object],[object Object],[object Object]
Extradural haematoma Respects the suture lines. Seen on CT Brain as lens- shaped blood collection with a convex medial border .
Acute Subdural haematoma ,[object Object],[object Object],[object Object],[object Object],[object Object]
Acute Subdural haematoma Appear on Ct Brain as crescent-shaped blood collections with a concave medial border. This does not resect the suture lines. Note also midline shift.
Subarachnoid haemorrhage ,[object Object],[object Object],[object Object]
Subarachnoid haemorrhage ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intracerebral haematoma ,[object Object],[object Object],[object Object],[object Object]
Diffuse axonal injury ,[object Object],[object Object],[object Object],[object Object],[object Object]
Monitoring of ICP ,[object Object],[object Object],[object Object],[object Object],[object Object]
Medical management of raised ICP ,[object Object],[object Object],[object Object],[object Object]
Medical management of raised ICP ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical management ,[object Object],[object Object],[object Object],[object Object]
Surgical management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Surgical management ,[object Object],[object Object],[object Object],[object Object]
 

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Head Injury Management and Monitoring

  • 1. Head Injury Niamh Bambury Lecturer in Surgery 18/09/08
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  • 15. Monroe-Kellie doctrine CSF Brain Blood Compensation occurs up to a value of 100mls. eg. an increase in lesion volume (e.g. extradural hematoma) will be compensated by the downward displacement of CSF and venous blood.
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  • 31. Extradural haematoma Respects the suture lines. Seen on CT Brain as lens- shaped blood collection with a convex medial border .
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  • 33. Acute Subdural haematoma Appear on Ct Brain as crescent-shaped blood collections with a concave medial border. This does not resect the suture lines. Note also midline shift.
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