Head Injury

Done By ; 1-Youssef Mohamed Youssef (241001 )

DEFINITION;
Any trauma that leads to injury of the scalp, skull, or brain.
The injuries can range from a minor scalp laceration to serious brain injury.
Coup: Injury at site of impact
Deceleration Contrecoup: Injury on opposite
• Head is moving and hits an side from impact
immobile object.
• Causes
Injury resulting from rapid, violent
movement of brain. 1. Motor vehicle accidents
• Brain continues moving in Acceleration
skull towards direction of 2. Falls
Immobile head is struck by a
Posterior impact, resulting in
moving object. 3. Assaults
Skull Base significant forces that
damage cells.
MECHANISM Skull moves away from force. 4. Sports-related injuries
fracture • BLUNT INJURY 5. Firearm-related injuries
•Bruising over 1. High Velocity •
Scalp injury Brain rapidly accelerates from Risk Population
occipital area.
2. 2-Low Velocity stationary to in-motion state
1. Males 15-24 years.
•Cranial nerve (1) Laceration or bruises causing cellular damage.
• PENETRATING
injuries (minor injury) 2. Males / females = 2/1
INJURY
Scalp is highly vascular 3. Infants & Young
1-Gunshot Children
(children may develop
CONCUSSION
shock) 2-Sharp instrument 4. Elderly
“Any trauma-induced alteration in
Major complication is
Morphological infection
mental status”
classification Temporary & brief interruption of
(2) Scalp hematoma TYPES OF BRAIN
• Scalp injuries neurological function without
INJURIES structural damage. SKULL
• Brain injuries
DIFFUSE Cause: shearing/stretching of white FRACTURES
• Skull fractures
The double ring sign matter fibres at time of impact →
•Concussion Anterior Skull Base
(Halo Sign) Test to ⸻ temporary neuronal dysfunction. fracture
•Diffuse Axonal Injury
determine CSF leakage: Symptoms
Diagnosed clinically.
FOCAL Brief confusion, disorientation.
• Leaking fluid drips onto a white Headache. •CSF rhinorrhea.
pad/towel. •Contusion and Dizziness.
•Epistaxis.
• Within a few minutes, the Lacerations Amnesia.
blood coalesces into center Return of consciousness moments or •Subconjunctival
Secondary •Epidural he and Subdural minutes after impact (within 30 hemorrhage.
and yellowish CSF appears as
Brain Injury he minutes).
halo. CT/MRI  Normal •Periorbital hematomas
•Subarachnoid hge (raccoon eyes).
Occurs at some time Post-concussive syndrome
after the moment of •Intracerebral hge Timing: 2 weeks to 2 months
impact Persistent headache
Primary Brain Injury fatigue
Preventable →
Personality changes
Improved outcome •Occurs at the time of Diffuse Axonal Decreased short-term memory Middle Skull Base
impact Injury fracture
•Mechanical damage is
Severe widespread
usually irreversible Acute Subdural •CSF otorrhea.
injury to axons in
•Permanent mechanical cerebral Hematoma •Hearing loss and
Cells of The cellular disruption hemispheres, corpus •Accumulates between dura and Hemotympanum
Nervous System •Microvascular injury. collosum, and brain arachnoid. •Battle sign (bruise
stem. behind the ear in mastoid
Neurons are most Includes: • Usually elderly, chronic
vulnerable to Clinical signs: alcoholics, infants (e.g., shaking region)
damaging effect of 1. Cerebral contusions
↓ LOC immediately baby syndrome). •Facial nerve palsy.
ischaemia-hypoxia 2. Diffuse axonal injuries
↑ ICP Source: •Vertigo & nystagmus.
and irreversible (DAI)
injury due to high Cognitive •Small bridging veins tear → small,
3. Cerebral lacerations
demands and no impairment, silent hematoma → enlarges →
energy store. spasticity mass effect.

Oligodendroglia CT → Usually normal •Brain laceration can also produce Cerebral oedema
Epidural hematoma
cells hematoma.
Collection of blood between Two types (often occur
are most dura and skull bones. together):
susceptible among Signs within 48 hours of injury.
Source: Arterial (MMA) - middle 1-Vasogenic edema:
glial cells, followed Clinical presentation
meningeal artery Major trauma (Shearing Forces). localized or generalized
by astrocytes.
Progressive severe headache Mortality rate up to 40%. 2-Cytotoxic edema:
Microglial cells Pathophysiology:
(several minutes) intracellular (neuronal &
and vascular Fracture of temporal bone
Nausea and projectile vomiting glial)
endothelium ruptures MMA → Rapid clinical
survive the longest. Focal neurological deficits Cerebral contusions
deterioration.
Decreased level of • Coup and countercoup injuries Complications:
1. Brief LOC
consciousness • Affecting inferior frontal fossa Raise pressure inside fixed
2. Drowsiness
Brain herniation and temporal lobes. skull capacity
3. Dizziness
• CT: heterogeneous with mixed •Herniations
4. Nausea, vomiting areas of high and low density.
•Infarction
• Cerebral edema.