TBI, Subdural Hematoma, and Neurologic Deterioration

Vocabulary practice flashcards covering the pathophysiology, biomechanics, clinical presentation, and acute management of traumatic brain injury and subdural hematomas.

Traumatic Brain Injury (TBI)

Brain dysfunction resulting from an external force such as a fall, collision, or impact.

Subdural Hematoma (SDH)

Extravasation of blood within the subdural space, located between the dura mater and the arachnoid layer, commonly originating from torn low-pressure bridging cortical veins.

Coup Injury

The primary focal contusion sustained directly at the anatomical site where the skull strikes an external object.

Contrecoup Injury

Secondary injury occurring when the mobile brain accelerates backward within the cranial cavity after the skull halts, impacting the opposite inner skull wall.

Bridging Cortical Veins

Low-pressure vessels that traverse the subdural space and are susceptible to tearing from acceleration-deceleration forces or stretching due to cerebral atrophy.

Cerebral Atrophy

An age-related process that widens the subdural space and stretches bridging veins, predisposing older adults to hematomas even from minor trauma.

First Priorities After Head Trauma

Airway and cervical spine precautions as indicated, breathing, circulation, and serial neurologic assessment.

Signs of Neurologic Deterioration

Clinical indicators of worsening TBI or expanding hematoma, including declining level of consciousness, worsening headache, vomiting, new weakness, pupil changes, and seizures.

Non-Contrast Head CT

A diagnostic imaging scan utilized to detect acute intracranial hemorrhage and structural injury, which may initially appear negative in delayed-presentation hematomas.

Subdural Venous Bleeding Velocity

A slow progression of bleeding stemming from a low-pressure venous source that often accumulates insidiously over days to weeks.

Eliquis

An anticoagulant prescribed to prevent deep vein thrombosis that heightens clinical concern for intracranial bleeding following head trauma.

4-Factor Prothrombin Complex Concentrate (4-Factor PCC / Kcentra)

A targeted pharmacological agent administered alongside Vitamin K to rapidly reverse prolonged coagulation times prior to intervention in anticoagulated clients.

Mannitol

An osmotic diuretic administered to suppress acute intracranial pressure (ICP) spikes in the management of traumatic brain injury.

Surgical Evacuation / Decompression

An urgent neurosurgical procedure performed via burr holes or formal craniotomy to remove large subdural hematomas and relieve physical brain tissue shifting.

Midline Brain Shift

A profound displacement of brain structures caused by an extensive, space-occupying intracranial hematoma.