PAT 20A/B Study Guide - Final Guide: Intracerebral Hemorrhage, Glasgow, Abnormal Posturing
PAT20B 1
PAT 20B Notes Week 8
BRAIN INJURY
HEMATOMAS
o Result from vascular injury and bleeding
o Bleeding can occur in any of several compartments
EPIDURAL HEMATOMA
Caused by head injury in which the skull is fractured
Develops between the inner table of the bones of the skull and
the dura
Results from a tear in an artery, most often the middle
meningeal
o Associated with a skull fracture
Injury to the temporal lobe has a high risk for epidural
hematomas
Common in younger people
The dura is less firmly attached to the skull surface in younger
people than older people
The dura can be easily separated from the inner surface of the
skull, allowing the hematoma to grow
PRESENT WITH:
History of head injury
Brief period of unconsciousness followed by a lucid
interval
a temporary improvement in a patient's
condition after a traumatic brain injury, after
which the condition deteriorates ✄
A lucid interval is especially indicative of an
epidural hematoma ✄
The lucid interval does not always occur or
may be missed as it is brief, but when
observed it is of great diagnostic value
With rapidly developing unconsciousness
Focal symptoms r/t to the area of the brain involved
Ipsilateral ( same side) pupil dilation
Contralateral (opposite side) hemiparesis
from uncalherniation
Aka epidural hemorrhage◪
A collection of blood that results from bleeding between
the dura and the inner surface ◪
o Buildup of blood between the dura mater and the
skull
As hematoma forms, it strips dura away from skull◪
Associated with skull fracture◪
Usually develops from a tear in meningeal artery ★◪
o linear fracture to the thin squamous portion of the
temporal bone
Laceration of the middle meningeal artery
Since this is an arterial bleed—it rapidly expands – leading
to a rapid deterioration in neurological status◪
Neurological Emergency – venous or arterial origin ◪
Classic Signs include:
1. Patient unconscious immediately after trauma
2. Patient is awake and lucid
3. Loss of consciousness occurs and PERRLA
deteriorates, eye movement paralysis on same
side of hematoma ( fixed dilated pupil on
affected side – ipsilateral pupil dilation)
4. Patient lapses into coma
Unconsciousness at the scene with a brief lucid interval
followed by a decrease in LOC, headache, N&V★★★
Possible seizures✈
IF THE HEMATOMA IS NOT REMOVED
The condition progresses
Increased ICP
Tentorial herniation
Death
Prognosis is excellent if the hematoma is removed BEFORE
loss of consciousness occurs
Document Summary
Hematomas: result from vascular injury and bleeding, bleeding can occur in any of several compartments. Caused by head injury in which the skull is fractured. Develops between the inner table of the bones of the skull and. A collection of blood that results from bleeding between. Results from a tear in an artery, most often the middle meningeal: associated with a skull fracture. Injury to the temporal lobe has a high risk for epidural hematomas. The dura is less firmly attached to the skull surface in younger people than older people. The dura can be easily separated from the inner surface of the skull, allowing the hematoma to grow. Brief period of unconsciousness followed by a lucid interval a temporary improvement in a patient"s condition after a traumatic brain injury, after which the condition deteriorates . A lucid interval is especially indicative of an epidural hematoma .