ATLS MODULE 6 HEAD TRAUMA
1. For patients with right/left or upper/lower deficit how to do you calculateGCS
Answer: use response on better side
2. GCS
Answer: Eye movement+ Motor involvement+ speech
E=M=S
3. epidural hematoma
Answer: Uncommon
a collection of blood in the space between the skull and dura mater
Classically arterial
Often result from middle meningeal tear from fracture
Classic presentation: lucid interval between injury and neurological deficit.Appears
lenticular or biconvex on CT
4. Subdural hematoma
Answer:
pertaining to below the dura mater, tumor of blood
MC than epidural hematoma
Typically from tears of bridging veins
Damage is severe due to underlying brain injuryAppear to cover cerebral surface on
CT
5. cerebral contusions
Answer: Fairly common- 20-30% of severe brain injuries.
, In the frontal and temporal lobes
Can evolve to form over hours or days intracerebral hematomas or coalescent
contusions that may require surgical evaluation.
Repeat CT scanning is warranted due to progressive changes.
6. What types of intracranial hemorrhage can be seen on CT scan?
Answer: epidural,subdural, intra-ventricular hemorrhage, subarachnoid hemorrhage,
intra-parenchymal.
7. basal cisterns
Answer: prepontineinterpeduncular (btwn grooves)ambient (lat)
quadrigeminal (post) (suprasellar is suprasella)
8. Indications for head CT in patients with mild TBI
Answer: required for patients with suspected mild TBI (witnessed loss of
conciousness, definite amnesia, or witnesseddisorientation in a patient with GCS of
13-15 +:
High risk features:
-GCS score < 15 at 2 hours after injury
-suspected skill fracture
->2 episodes of vomiting
-Age > 65
-anticoagulant use
Moderate risk features:
Loss of conciousness (<5 mins) Amnesia before impact (>30 mins)
Dangerous mechanism (impacted by vehicle, ejected from vehcile, fall from more
than 3 feet or 5 stairs)
9. Mgmt of mild brain injury
Answer: Most patients make uneventful recoveries
Secondary surgery is critical (mechanism of injury, loss of consciousness, seizure
activity, etc...)
Serial exam and GCS scoring are important
1. For patients with right/left or upper/lower deficit how to do you calculateGCS
Answer: use response on better side
2. GCS
Answer: Eye movement+ Motor involvement+ speech
E=M=S
3. epidural hematoma
Answer: Uncommon
a collection of blood in the space between the skull and dura mater
Classically arterial
Often result from middle meningeal tear from fracture
Classic presentation: lucid interval between injury and neurological deficit.Appears
lenticular or biconvex on CT
4. Subdural hematoma
Answer:
pertaining to below the dura mater, tumor of blood
MC than epidural hematoma
Typically from tears of bridging veins
Damage is severe due to underlying brain injuryAppear to cover cerebral surface on
CT
5. cerebral contusions
Answer: Fairly common- 20-30% of severe brain injuries.
, In the frontal and temporal lobes
Can evolve to form over hours or days intracerebral hematomas or coalescent
contusions that may require surgical evaluation.
Repeat CT scanning is warranted due to progressive changes.
6. What types of intracranial hemorrhage can be seen on CT scan?
Answer: epidural,subdural, intra-ventricular hemorrhage, subarachnoid hemorrhage,
intra-parenchymal.
7. basal cisterns
Answer: prepontineinterpeduncular (btwn grooves)ambient (lat)
quadrigeminal (post) (suprasellar is suprasella)
8. Indications for head CT in patients with mild TBI
Answer: required for patients with suspected mild TBI (witnessed loss of
conciousness, definite amnesia, or witnesseddisorientation in a patient with GCS of
13-15 +:
High risk features:
-GCS score < 15 at 2 hours after injury
-suspected skill fracture
->2 episodes of vomiting
-Age > 65
-anticoagulant use
Moderate risk features:
Loss of conciousness (<5 mins) Amnesia before impact (>30 mins)
Dangerous mechanism (impacted by vehicle, ejected from vehcile, fall from more
than 3 feet or 5 stairs)
9. Mgmt of mild brain injury
Answer: Most patients make uneventful recoveries
Secondary surgery is critical (mechanism of injury, loss of consciousness, seizure
activity, etc...)
Serial exam and GCS scoring are important
