head injury & TBIs

What are the types of head injuries?

Abrasions, lacerations, traumatic brain injury (including concussion and subdural hematoma).

What is a concussion?

A mild head injury that may cause temporary loss of consciousness and can be asymptomatic.

What is diffuse axonal injury (DAI)?

Injury from stretching or tearing of neurons due to rotation or rebound of the brain during impact.

How are head injuries classified based on Glasgow Coma Scale (GCS)?

Mild: GCS 13-15, Moderate: GCS 9-12, Severe: GCS 8 or less. IF THE SCORE IS 8 THEN INTUBATE!!

What are primary and secondary injuries in head trauma?

Primary injuries occur at the moment of impact, while secondary injuries develop due to inflammation, vasospasm, and ischemia days after the initial injury.

What are some risk factors for head injuries?

High-risk groups include children, young adults, elderly individuals, and males. Causes include nonaccidental trauma, motor vehicle crashes, falls, and physical assaults.

What are the clinical manifestations of mild traumatic brain injury (TBI)?

Loss of consciousness for seconds to minutes, headache, confusion, dizziness, blurred vision, and changes in behavior or mood.

What are the clinical manifestations of moderate to severe TBI?

Loss of consciousness for minutes to hours, persistent headache, seizures, loss of vision, and difficulty understanding or communicating.

What are some assessment findings that suggest a skull fracture?

Rhinorrhea or otorrhea, periorbital edema (raccoon eyes), and postauricular ecchymosis (Battle's sign).

What tests can confirm cerebrospinal fluid (CSF) leakage?

Dextrostix test for glucose presence and the halo sign test for fluid collection.

What imaging studies are commonly used for head injuries?

CT scans for initial imaging, MRI for detailed tissue images, and X-rays for identifying penetrating injuries or skull fractures.

What is the role of the nurse in managing head injuries?

Client education, safety considerations, recognizing and analyzing cues, prioritizing hypotheses, and implementing and evaluating nursing actions.

What are the potential complications of traumatic brain injury?

Increased intracranial pressure (ICP), chronic conditions, cognitive difficulties, emotional disorders, and increased risk for falls.

What is chronic traumatic encephalopathy (CTE)?

A neuropathological brain disease associated with multiple TBIs, leading to cognitive, behavioral, and mood changes.

What are the pharmacological treatments for TBI?

Treatments include managing increased ICP, sedation, pain management, seizure prophylaxis, and fever control.

What surgical interventions may be required for TBI?

External ventricular drains, decompressive craniectomy, and therapeutic hypothermia.

What are the signs of increased intracranial pressure?

Decreased level of consciousness, restlessness, pupil dilation, and headache.

What is the pathophysiology of traumatic brain injury?

Injury caused by mechanical forces, leading to primary injuries like skull fractures and secondary injuries such as ischemia and cerebral edema.

What are the mechanisms of injury for head trauma?

Includes gunshot wounds, high-velocity impacts, low-velocity knife injuries, blunt trauma, and blast injuries.

What psychosocial changes can occur after a head injury?

Changes in personality, cognition, memory, and attention.

What physiological symptoms may follow a head injury?

Headache, photosensitivity, dizziness, and fatigue.

What is post-concussive syndrome?

A complex disorder characterized by persistent symptoms following a concussion.

What considerations are important for aging adults with head injuries?

Increased risk for subdural bleeding, brain atrophy, and more comorbidities.

What is the significance of the Glasgow Coma Scale (GCS) in head injuries?

It assesses the level of consciousness and severity of brain injury.

What are common nursing assessments for clients with TBI?

Monitoring level of consciousness, airway and ventilation, and recognizing signs of worsening condition.

What is the impact of comorbidities on TBI outcomes?

Co-existing conditions can complicate diagnosis and affect recovery.

Agnosia

Failure to recognize familiar objects

Agraphia

Inability to write

Aphasia

Difficulty with speech and/or comprehension

Alexia

Inability to read

Ansomnia

Loss of smell