Head injury ManagementHead injury Management

Dr Y R YadavDr Y R Yadav

NSCB Medical College JabalpurNSCB Medical College Jabalpur

Head injury ManagementHead injury Management

•Injury to skull or brain, not scalpInjury to skull or brain, not scalp•Primary v/s Secondary damagePrimary v/s Secondary damage•Aim of treatment: prevent Sec.Aim of treatment: prevent Sec.

Insult. Insult.

Head injury Management Head injury Management Secondary InsultsSecondary Insults

• Extra cranial:

Hypoxia

Hypotension

Fever

Electrolyte

Imbalance

• Intracranial:

Hematoma

Hydrocephalus

Meningitis

Cerebral Edema

Seizures

Head injury Management Head injury Management PathophysiologyPathophysiology

• Disease neuron ----Proper treatment ----

survive

Disease and normal neuron----Sec Insult—

death of neuron

Head injury ManagementHead injury Management

• History: Mode of accident Loss of consciousness: Duration, Lucid interval Vomiting ENT Bleeding Headache Seizure Progress

Head injury ManagementHead injury Management

• Examination:• CNS: GCS Pupil Localizing signs• Local: Scalp• General Examination: R / O other injury Chest, Abdomen, Cervical spine, BP, Airway, Pulse.

Head injury ManagementHead injury Management

• Investigations:

X-Ray Skull

X-Ray C-Spine

X-Ray Chest

CT Scan Head

EDHEDH

Acute SDHAcute SDH

Head injury ManagementHead injury Management

• Management:• Prevention of Sec insult.• Treatment of raised ICP: Frusimide, Mannitol, Head UP, Acetazolamide, Glycerol.• Fluid and electrolyte• Surgery: Hematoma/ Contusion Depressed fracture Hydrocephalus• Anticonvulsants.

Head injury ManagementHead injury Management