ATLS Head Trauma
What is the percentage of prehospital trauma-related deaths related to brain injury?
90%
What is the most common impairment TBI survivors exhibit
Neuropsychological impairment leading in disability
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What is the primary goal of patients with suspected TBI?
Prevention of secondary brain injury
What are the most important ways to limit secondary brain injury?
Ensure adequate oxygenation & maintain blood pressure
Following A-E assessment when do you transfer a HI patient?
When head trauma has been determined by clinical examination (without delay, with early
neurosurgical consultation). CT scanning should not delay patient transfer to trauma centre that
is capable of immediate and definitive neurosurgical intervention
What information should be communicated on the web attaining neurosurgical consultation for
TBI patients?
Age, Mechanism & time of injury,
Respiratory & cardiovascular status,
, Neuro exam (GCS, Pupil size, response to light),
Focal neurological deficits,
Abnormal neuromuscular status
Associated injuries
Diagnostic studies, CT scan if available
Anticoagulants
What can lead to increased risk of major blood loss from scalp laceration?
Long hospital transport
Pathophysiology of epidural haematoma?
Laceration of meningeal arteries that lie between the dura and the internal surface of the skulls
in the epidural space. Most commonly injurer artery is the middle meningeal artery. Expanding
epidural haematoma can lead to rapid deterioration and death
Where does the venous blood from the midline superior sagittal sinus drain into?
Bilateral transverse & sigmoid sinuses (usually larger on the right)
Where do meningeal arteries lie
Pathophysiology if the subdural haeamtoma?
Bridging veins that travel from the surface of the brain to the venous sinuses within the dura
may tear.
Pathophysiology of Subarachnoid haemorrhage:
Nerve responsible for pupil contriction
Parasympathetic fibres of third cranial nerve (Oculomotor)
Herniation leads to compression of these fibres leading to unopposed sympathetic activity -
blown pupil
Nerve responsible for pupil for dilatation
Define uncal herniation.
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