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Lecture 7

NURS 364 Lecture Notes - Lecture 7: Diffuse Axonal Injury, Retrograde Amnesia, Peripheral Nervous System


Department
Nursing
Course Code
NURS 364
Professor
Deborah Van Kuiken
Lecture
7

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Disorders of the Central and Peripheral Nervous Systems and the Neuromuscular Junction
NURS 364
Brain Trauma
Major head trauma
A traumatic insult to the brain possibly producing physical, intellectual, emotional,
social, and vocational changes
Causes: Transportation accidents, Falls, Sports-related event, Violence
High Risk Groups:
Young children less than 4 years old,
age 15-19,
age greater than 65, and
males--- sports and impulsive behaviors
Brain Trauma (cont’d)
Open (penetrating, missile) trauma
Injury breaks the dura and exposes the cranial contents to the environment
Causes primarily focal injuries
Brain Trauma (cont’d)
Closed (blunt, non-missile) trauma
Head strikes hard surface or a rapidly moving object strikes the head
The dura remains intact and brain tissues are not exposed to the environment
Results in
focal (local): contusions, hematoma
diffuse (general) brain injuries: concussion, diffuse axonal injury
Brain Trauma (cont’d)
Contusion---- think of as a brain bruise, bleeding within the brain
Observable brain lesion
Force of impact typically produces bleeding & contusions from small tears in blood
vessels
Coup injury
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Injury directly below the point of impact--- confusion
Contrecoup
Injury on the pole opposite the site of impact--- visual problems
Focal Brain Injury
Observable brain lesion
Force of impact typically produces contusions
Contusions can cause:
Extradural (epidural) hemorrhages or hematomas----- bleeding outside of dura
Subdural hematomas----- bleeding in space right under the dura
Intracerebral hematomas—bleeding inside brain matter
Hematomas from Brain Trauma
Hematomas (cont)
-
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Subdural Hematomas
Acute
Rapid & high mortality rate
Subacute
Less rapid with some improvement
Chronic
Symptoms occur weeks after injury
Common in older patients--- and with alcohol abuse
Severing of bridging veins
Diffuse Brain Injury
Diffuse axonal injury (DAI)
Shaking, inertial effect
Acceleration/deceleration
Axonal damage
Shearing, tearing, or stretching of nerve fibers
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