PATHOPHYSIOLOGY

2 forms of damage to the

brain from TBI.

1.Primary Brain Injury

2.Secondary brain injury
 Defined as the consequence of direct
contact to the head/brain during the instant of
initial injury, causing extracranial focal injuries
(contusions, lacerations, external hematomas
and skull fractures), as well as possible focal
brain injuries from sudden movement of the
brain within the cranial vault (subdural
hematomas, concussion, diffuse axonal injury.
 Primary Brain Injury

Diffuse Focal

Blunt Sharp

• Foreign body
• Coup • Depressed skull
• coutrecoup fracture
 PRIMARY BRAIN INJURY

Diffuse Focal

Cerebral confussion

Diffuse axonal injury

– Evolves over the ensuing hours and days
after the initial injury and results from
inadequate delivery of nutrients and oxygen to
the cells.
 SECONDARY BRAIN INJURY

Extracranial Intracranial

Intracranial Cerebral Subdural Extradural

hypertension haematoma haematoma Haematoma
NORMAL ICP 0-15 mmHg

Mile elevation 16-20mmHg

Moderate elevation 21-30mmHg

Severe elevation 31-40mmHg

Very severe elevation 41mmHg and above.

• Decreased level of consciousness,
confusion, restlessness, lethargy, difficulty
with memory and thinking.
• Pupillary disfunction
• Changes in vision
• Deterioration of motor function
• Headache, personality changes
• Decreasing glascow coma score.
Hypoxia

hyponatraemia

Hypotension hypercarbia Acidosis

 Common symptoms of a minor head
injury include:
•a headache
•lightheadedness
•a spinning sensation
•mild confusion
•nausea
•temporary ringing in the ears
 The symptoms of a severe head injury
include many of the symptoms of minor
head injuries. They can also include:

•a loss of consciousness
•seizures
•vomiting
•balance or coordination problems
•serious disorientation
Cont..

• an inability to focus the eyes

• abnormal eye movements
• a loss of muscle control
• a persistent or worsening headache
• memory loss
• changes in mood
• leaking of clear fluid from the ear or the nose
THANK YOU!
DONES, JOYCE ANN S.