HTHSCI 2F03 Lecture Notes - Lecture 10: Focal Neurologic Signs, Traumatic Brain Injury, Codeine
26 Dec 2020
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Head injury, alone or in combination c other injuries, is the commonest cause of trauma death (50%) Occurs @ time of injury and is a result of direct or indirect injury to brain tissue. May coma and persistent vegetative state. Cranium is rigid box total volume of intracranial contents must remain constant if icp is not to change. In volume of one constituent compensatory in another: These mechanisms can compensate for a volume change of ~100ml before icp . As autoregulation fails, icp rapidly herniation. Cbf cpp x radius of vessels. Autoreg vasodilatation volume icp . Csf rhinorrhoea or otorrhoea (test: halo sign) Gcs: <13 @ scene, <15 2h later. Bloods: fbc, u+e, glucose, clotting, etoh level, abg. Not returned to gcs 15 after imaging. Neuro obs: half hrly until gcs 15/15. Abx: if open / base of skull # Pao2 <9kpa on air / <13kpa on o2 or pco2 >6kpa. V. painful headache that won"t go away.
