Head trauma (main): Difference between revisions
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== Background == | == Background == | ||
[[File:TBI GCS.jpg|thumb]] | |||
*Classification based on [[GCS]] | *Classification based on [[GCS]] | ||
**14-15: Mild | **14-15: Mild | ||
**9-13: Moderate | **9-13: Moderate | ||
**3-8: Severe | **3-8: Severe | ||
== Diagnosis == | == Diagnosis == | ||
Revision as of 22:11, 4 May 2015
Background
- Classification based on GCS
- 14-15: Mild
- 9-13: Moderate
- 3-8: Severe
Diagnosis
- Monitor for increased ICP
- HA, N/V, sz, lethargy, HTN, bradycardia, agonal respirations, posturing
- Monitor for herniation
- Ipsilateral fixed and dilated pupil
- Contralateral motor paralysis
- B/l pinpoint pupils suggests opiate use or pontine lesion
Workup
Workup
- Consider head CT (rule out intracranial hemorrhage)
- Use validated decision rule to determine need
- Avoid CT in patients with minor head injury who are at low risk based on validated decision rules.[1]
- Consider cervical and/or facial CT
Differential Diagnosis
Intracranial Hemorrhage Types
- Intra-axial
- Hemorrhagic stroke (Spontaneous intracerebral hemorrhage)
- Traumatic intracerebral hemorrhage
- Extra-axial
- Epidural hemorrhage
- Subdural hemorrhage
- Subarachnoid hemorrhage (aneurysmal intracranial hemorrhage)
Concussion
Maxillofacial Trauma
- Ears
- Nose
- Oral
- Other face
- Zygomatic arch fracture
- Zygomaticomaxillary (tripod) fracture
- Related