HEAD INJURY

Amrit Kumar Saikia

 ACCIDENTAL

MODE
C NONACCIDENTAL
L
A
CLOSED/BLUNT/NON-MISSILE
S
S TYPE
I PENETRATING/MISSILE
F
I MILD
C
SEVERITY
A MODERATE
T
I SEVERE
O
PRIMARY/IMMEDIATE
N PATHOPHYSIOLOGY
SECONDARY/DELAYED

FOCAL
DISTRIBUTION
Diffuse axonal injury
 DAI – Survival 28hrs Contusions + DAI- Survival 48hrs

DAI – hemorrhages in rostral pons, and Healing DAI. Survival – 6days(Luxol Fast Blue)
tectum, with Duret h’ages in midline
Dept of Neuropathology,NIMHANS
INTRACRANIAL
HEMORRHAGES :
Extra- axial hemorrhage
Epidural hematoma
Subdural hematoma-
Acute
Chronic
Subarachnoid hemorrhage
Intra-axial hemorrhage
Intra-parenchymal hemorrhage
Intra-ventricular hemorrhage
Right temporoparietal EDH
Acute SDH
ACUTE SDH
CHRONIC SUBDURAL HEMATOMA
 SAH:

Dept of neuropathology,NIMHANS
BASAL CISTERNAL TRAUMATIC SAH
HALO SIGN ” ON CLOTHES OF LINEN
Normal CT Depressed fracture
DEPRESSED FRACTURES:-
BASILAR SKULL FRACTURE
SUBFALCINE HERNIATION:-
UNCAL HERNIATION
TRAUMA CARE SYSTEM
 MODEL TRAUMA CARE SYSTEM
Prevention Helmet,Alcohol,Traffic rules

Prehospital Care Trained Paramedicals

Transportation Dedicated Ambulances

Gen Hospital Training GPs, Telemedicine.

Online database

Specialized centre Infrastructure,Man-power

Rehabilitation Speciality care

Feedback Budgets, Policies, Training

PUPILS
 Note size, symmetry
 Light reaction

Bilateral
dilated and
Non reactive

Irreversible Bilateral
midbrain transtentorial
lesion herniation
 Delayed onset 3
Unilateral pupil
dilatation and loss of
Nerve paresis
Light reaction With opp.
hemiparesis

Traumatic Classical sign of

3 cranial nerve lateral
paresis
Transtentorial
( ptosis and divergent
squint) herniation
SKIN CARE TO TREAT OR HELP PREVENT
PRESSURE SORES
CARE TO PREVENT CHOKING AND
FACILITATE BREATHING
REDUCING THE RISK OF LIMB DEFORMITY
GOLDEN WORDS:
“No head injury is minor to be
neglected

Nor serious enough to be given up”

-Hippocrates
Thank you