Head Injury

Head Injury

A head injury is any sort of injury to brain, skull, or scalp.

Common head injuries include concussions, skull fractures, and scalp wounds. The consequences and treatments vary greatly, depending on what caused your head injury and how severe it is.

Head Injury

Head injury can include fractures to the skull and face, direct injuries to the brain (as from a bullet) and indirect injuries to the brain (such as concussion, contusion or intracranial Haemorrhage).

Head injuries commonly occur from motor vehicle accidents, assaults or falls.

Key terms

Concussion: A temporary loss of consciousness

Contusion: A bruising of the brain tissue.

Intracranial Haemorrhage: Significant bleeding into a space or a potential space between the skull and the brain.

Haematomas: Collections of blood that develop within the cranial vault are the most serious results of brain injury.

Head injuries causes by a blow to the head are usually associated with:

·              Motor vehicle accidents

·              Falls

·              Physical assaults

·              Sports-Related Accidents

Specific Problems after Head  Injury Includes

Concussion Skull fracture, Lacerations to the scalp and resulting haemorrhage of the skin, Traumatic subdural haematoma, Traumatic extradural, or epidural haematoma, Traumatic subarachnoid haemorrhage, Cerebral contusion, (a bruise of the brain), a loss of motor sensory an reflex function due to trauma, a severe injury may lead to a coma or death.

Signs and Symptoms

·              Vertigo

·              Pain

·              Changes in vital signs

·              Immobility

·              Visual and hearing impairment

·              Bleeding

·              Nausea and Vomiting

·              Loss of consciousness

·              Seizures

·              Leaking of clear CSF fluid from the ear or the nose

Diagnosis

·              History

·              Physical Examination

·              Complete blood counts

·              Coagulation studies

·              Arterial Blood Gas (ABG)

·              X-rays

·              CT Scans

·              MRI (Magnetic Resonance Imaging)

·              Glasgow Coma Scale (GCS)

·              Increased Intra Cranial Pressure (ICP)

Management

·              Maintenance of Airway: Oral suction

·              Administer high-flow oxygen.

·              Control Bleeding.

·              Intravenous fluid (IVF) – to prevent hypovolemic shock.

·              Maintain normothermia

Pharmacotherapy

·              Anticonvulsants – to control seizures

·              Diuritics – to reduce cerebral edema.

·              Antibiotics – to prevent infection

·              Antipyretics – to control hyperthermia

·              Cortico steroid - to reduce intracranial pressure

·              In severe condition of brain injury, the anti-seizure medication is very essential, because the patient is at risk for seizures.

·              Diuretics may be given if injury has caused pressure buildup in brain. Diuretics cause to excrete more fluids. This can help relieve some of the pressure.

Surgery

·              Surgical decompression

·              Craniotomy: Surgical incision into the cranium (may be necessary to evacuate a hematoma or evacuate contents)

·              Ventriculostomy: insertion of a drain into the ventricles.

Nursing Management

·               Assess the neurologic and respiratory status.

·              Monitor and record vital sign and intake and output.

·              Check cough and gag reflex to prevent aspiration.

·              Administer IV fluids to maintain hydration.

·              Providing Suctioning to maintain airway

·               Provide eye, skin and mouth care to prevent tissue damage.