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    Brain Injury: Closed (Blunt) Brain Injury Occurs When The Head Accelerates and Then

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    cute_tinee
    There are two types of brain injury - closed and open. Closed injuries occur when the head rapidly accelerates and decelerates without skull penetration. Open injuries involve skull penetration by an object. Clinical manifestations of brain injury include altered consciousness, neurological deficits, and changes in vital signs. Specific types of brain injuries discussed are concussion, contusion, diffuse axonal injury, and various types of intracranial hemorrhages and hematomas. Management involves supportive care, controlling intracranial pressure, monitoring for neurological changes, and preventing further injury.

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    Brain Injury: Closed (Blunt) Brain Injury Occurs When The Head Accelerates and Then

    Uploaded by

    cute_tinee
    175 views7 pages
    There are two types of brain injury - closed and open. Closed injuries occur when the head rapidly accelerates and decelerates without skull penetration. Open injuries involve skull penetration by an object. Clinical manifestations of brain injury include altered consciousness, neurological deficits, and changes in vital signs. Specific types of brain injuries discussed are concussion, contusion, diffuse axonal injury, and various types of intracranial hemorrhages and hematomas. Management involves supportive care, controlling intracranial pressure, monitoring for neurological changes, and preventing further injury.

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    Brain Injury

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    There are two types of brain injury - closed and open. Closed injuries occur when the head rapidly accelerates and decelerates without skull penetration. Open injuries involve skull penetration by an object. Clinical manifestations of brain injury include altered consciousness, neurological deficits, and changes in vital signs. Specific types of brain injuries discussed are concussion, contusion, diffuse axonal injury, and various types of intracranial hemorrhages and hematomas. Management involves supportive care, controlling intracranial pressure, monitoring for neurological changes, and preventing further injury.

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    Download as doc, pdf, or txt
    175 views7 pages

    Brain Injury: Closed (Blunt) Brain Injury Occurs When The Head Accelerates and Then

    Uploaded by

    cute_tinee
    There are two types of brain injury - closed and open. Closed injuries occur when the head rapidly accelerates and decelerates without skull penetration. Open injuries involve skull penetration by an object. Clinical manifestations of brain injury include altered consciousness, neurological deficits, and changes in vital signs. Specific types of brain injuries discussed are concussion, contusion, diffuse axonal injury, and various types of intracranial hemorrhages and hematomas. Management involves supportive care, controlling intracranial pressure, monitoring for neurological changes, and preventing further injury.

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    BRAIN INJURY

    Closed (blunt) brain injury occurs when the head accelerates and then
    rapidly decelerates or collides with another object (e.g., a wall or dashboard
    of a car) and brain tissue is damaged, but here is no opening through the
    skull and dura.

    Open brain injury occurs when an object penetrates the skull, enters the
    brain, and damages the soft brain tissue in its path (penetrating injury).

    CLINICAL MANIFESTATIONS OF BRAIN INJURY:

    • Altered level of consciousness

    • Confusion

    • Pupillary abnormalities (changes in shape, size, and response to light)

    • Altered or absent gag reflexes

    • Absent corneal reflex

    • Sudden onset of neurologic deficits

    • Changes in vital signs (altered respiratory pattern, hypertension,


    bradycardia, tachycardia, hypothermia, or hyperthermia)

    • Vision and hearing impairment

    • Sensory dysfunction

    • Spasticity

    • Headache

    • Vertigo

    • Movement disorders

    • Seizures
    Concussion

    - A cerebral concussion is a temporary loss of neurologic function with no


    apparent structural damage.

    Contusion

    - A cerebral contusion is more severe injury in which the brain is bruised,


    with possible surface hemorrhage. The patient may lie motionless, with a
    faint pulse, shallow respirations and coo, pale skin. Often there is
    involuntary evacuation of the bowels and the bladder.

    Diffuse Axonal Injury

    - Diffuse axonal injury involves widespread damage to axons in the


    cerebral hemisphere, corpus callosum, and brain stem.

    Intracranial Hemorrhage

    - Hematomas that develop within the cranial vault are the most serious
    brain injuries. Major symptoms are frequently delayed until the
    hematoma is large enough to cause distortion of the brain and increased
    ICP.

    Epidural Hematoma (Extradural hematoma or Hemorrhage)

    - After a head injury, blood may collect in the epidural space between the
    skull and the dura. This can result from a skull fracture that causes a
    rupture or laceration of the middle meningeal artery, the artery that runs
    between the dura and the skull inferior to a thin portion of temporal bone.

    - Symptoms are caused by the expanding hematoma. Usually, there is a


    momentary loss of consciousness at the time of injury, followed by an
    interval of apparent recovery (lucid interval). Although the lucid interval
    is considered a classic characteristic of an epidural hematoma. During the
    lucid interval, compensation for the expanding hematoma takes place by
    rapid absorption of CSF and decreased intravascular volume, both of
    which help maintain a normal ICP. Then often suddenly, signs of
    compression appear (usually deterioration of consciousness and signs of
    focal neurologic deficits such as dilation and fixation of a pupil or
    paralysis of an extremity), and the patient deteriorates rapidly.

    SUBDURAL HEMATOMA
    - A subdural hematoma is a collection of blood between the dura and the
    brain, a space normally occupied by a thin cushion of fluid.

    ACUTE & SUBACUTE SUBDURAL HEMATOMA

    - Acute subdural hematoma are associated with major head injury


    involving contusion or laceration.

    - Sub acute subdural hematoma are the result of less severe contusion and
    head trauma.

    CHRONIC SUBDURAL HEMATOMA

    - Chronic subdural hematoma can develop from seemingly minor head


    injuries and are seen most frequently in the elderly.

    - A chronic subdural hematoma resembles other conditions and may be


    mistaken for a stroke.

    - Clinical signs and symptoms maybe severe headache, alternating focal


    neurologic signs; personality changes; mental deterioration; and focal
    seizures.

    - The treatment of a chronic subdural hematoma consists of surgical


    evacuation of the clot. The procedure may be carried out through
    multiple burr holes, or a craniotomy may be performed for a sizable
    subdural mass that cannot be suctioned or drained through burr holes

    INTRACEREBRAL HEMORRHAGE AND HEMATOMA

    - Intracerebral hemorrhage is bleeding into the substance of the brain.

    - These hemorrhage within the brain may also result from systemic
    hypertension, which causes degeneration and rupture of a vessel; rupture
    of a saccular aneurysm; vascular anomalies; intracranial tumors;
    systemic causes, including bleeding disorders such as leukemia,
    hemophilia, aplastic anemia, and thrombocytopenia; and complications of
    anticoagulant therapy.
    Management:

    • supportive care

    • control of ICP

    • careful administration of fluids &electrolytes

    • antihypertensive medications

    Management of Brain Injuries:

    • CT and MRI

    • Position emission tomography (PET scan)

    Nursing Interventions

    • Monitoring for declining neurologic function

    • Level of Consciousness

    • Vital signs

    • Motor function

    • Other neurologic signs

    • Monitoring fluid and electrolyte balance

    • Promoting adequate nutrition

    • Preventing injury

    • Maintaining body temperature

    • Maintaining skin integrity

    • Improving cognitive functioning

    • Preventing sleep pattern disturbance


    • Supporting family coping
    Pathophysiology:

    Brain suffers traumatic injury

    Brain swelling or bleeding

    increase intracranial volume

    Rigid cranium allows no room for

    expansion of contents so intracranial

    pressure increases

    Pressure on blood vessels within

    the brain causes blood flow to

    the brain to slow

    Cerebral hypoxia and ischemia occur


    Intracranial pressure continues to

    rise. Brain may herniate

    Cerebral blood flow ceases

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