General
the total volume of intracranial contents must remain constant, because the cranium is a rigid container incapable of expanding
Monroe-Kellie Doctrine
Secondary brain injury can occur after one episode of these
hypotension / hypoxia
Results from tearing of bridging veins
Subdural
GCS 13-15
mild
normal ICP
5-15
Early signs of neurological deterioration include
Headache, drowsiness, confusion, disorientation, agitation, irritability, nausea vomiting
Hallmark sign: period of lucidity between the time of injury and neurologic deterioration
Epidural hematoma
GCS 9-12
net pressure gradient driving oxygen delivery to the brain
CPP: Cerebral perfusion pressure (60-80)
Late signs of neurologic deterioration
Posturing, seizures, unilateral or bilateral pupil abnormalities, vital sign changes
3 hours from time of injury to administration of this medication to decrease intracranial hemorrhage
TXA
GCS 3-8
severe
Equation to determine CPP
MAP-ICP = CPP
Bradycardia, irregular respirations, widened pulse pressure
Cushing's Triad
periorbital ecchymosis, Battle's sign, CSF leakage from nose
Basilar skull fracture
True or False: a GCS can be scored as 0
False
Gold standard for identification of TBI
CT scan
Pharmacological interventions to decrease ICP
hypertonic saline, mannitol, sedatives, anaglesics, barbituates
diffuse brain injury resulting from a shearing effect
Diffuse axonal injury
True or False: when there is right vs left or upper vs lower asymmetry, the best motor score is used
True