Head Injury

AHN-II Semester-IV
Dr. Nadia Arif
Assistant Professor Pathology
Intracranial Pressure
 Intracranial pressure (ICP) is the pressure
exerted by fluids such as cerebrospinal fluid
(CSF) inside the skull and on the brain tissue
 ICP is measured in millimeters of mercury

(mmHg) and at rest, is normally 7–15 mmHg

for a supine adult
 Intracranial hypertension (IH), also called

increased ICP (IICP) or raised intracranial

pressure (RICP), is elevation of the pressure in
the cranium
Intracranial Pressure: Causes

 Too much cerebrospinal fluid (the fluid around your

brain and spinal cord)
 Bleeding into the brain
 Swelling in the brain
 Aneurysm
 Blood pooling in some part of the brain
 Brain or head injury
 Brain tumor
 Infections such as encephalitis or meningitis
 Hydrocephalus
Intracranial Pressure:Symptoms
 Headache
 Blurred vision
 Feeling less alert than usual
 Vomiting
 Changes in your behavior
 Weakness or problems with moving or talking
 Lack of energy or sleepiness
Intracranial Pressure:Diagnosis
 Medical history and physical exam including a
neurological exam to test senses, balance and mental
status
 Spinal tap (also called lumbar puncture), which
measures the pressure of cerebrospinal fluid
 Computed tomography (CT) scan, the gold standard
imaging test, creates a series of cross-sectional X-ray
images of the head and brain
 Magnetic resonance imaging (MRI) (used after the
initial assessment)uses magnetic fields to detect
subtle changes in brain tissue content and can show
more detail than X-rays or CT
Intracranial Pressure:Treatment
 Medicine to reduce swelling
 Draining extra cerebrospinal fluid or bleeding

around the brain

 Removing part of the skull (craniotomy) to

ease swelling (though this is rare)

Intracranial Pressure:Complications
 Seizures
 Stroke
 Neurological damage
 Death
Intracranial Pressure
 Severe headache
 Blurred vision
 Feeling less alert than usual
 Vomiting
 Changes in your behavior
 Weakness or problems with moving or talking
 Lack of energy or sleepiness
 Seizure
Head Injury
 A head injury is a broad term that describes a
vast array of injuries that occur to the scalp,
skull, brain, and underlying tissue and blood
vessels in the head.
 Head injuries are also commonly referred to

as brain injury, or traumatic brain injury (TBI),

depending on the extent of the head trauma.
Head Injury:Types
1. Concussion: an injury to the head area that
may cause instant loss of awareness or
alertness for a few minutes up to a few
hours after the traumatic event.
2. Skull fracture. A skull fracture is a break in
the skull bone.
3. Intracranial hematoma (ICH). There are
several types of ICH, or blood clots, in or
around the brain.
Head Injury: Causes
 motor vehicle accidents (automobiles,
motorcycles, or struck as a pedestrian)
 from violence
 from falls
 as a result of child abuse
 subdural hematomas and brain hemorrhages

(called intraparenchymal hemorrhages) can

sometimes happen spontaneously.
Head Injury: Pathophysiology
 Damages of neuronal tissues associated with
traumatic brain injury( TBI ) fall into two
categories:
(i) primary injury, which is directly caused by
mechanical forces during the initial insult
(ii) secondary injury, which refers to further
tissue and cellular damages following
primary insult.
Head Injury: Pathophysiology
Head Injury: Pathophysiology
Head Injury: Pathophysiology
Head Injury:Clinical Features
 Loss of consciousness
 Severe headache that does not go away
 Repeated nausea and vomiting

 Loss of short-term memory, such as difficulty

remembering the events that led right up to and

through the traumatic event
 Slurred speech
 Difficulty with walking
 Weakness in one side or area of the body

 Sweating
 Pale skin color
 Seizures or convulsions
Head Injury:Clinical Features
 Behavior changes including irritability
 Blood or clear fluid draining from the ears or nose
 One pupil (dark area in the center of the eye) is dilated, or looks

larger, than the other eye and doesn't constrict, or get smaller, when
exposed to light 
 Deep cut or laceration in the scalp
 Open wound in the head
 Foreign object penetrating the head
 Coma (a state of unconsciousness from which a person cannot be

awakened; responds only minimally, if at all, to stimuli; and exhibits

no voluntary activities)
 Vegetative state (a condition of brain damage in which a person has

lost his thinking abilities and awareness of his surroundings, but

retains some basic functions such as breathing and blood
circulation)
Head Injury:Diagnosis
 Blood tests

 X-ray. A diagnostic test that uses invisible electromagnetic energy beams to

produce images of internal tissues, bones, and organs onto film.

 Computed tomography scan (also called a CT or CAT scan). A diagnostic

imaging procedure that uses a combination of X-rays and computer technology
to produce horizontal, or axial, images (often called slices) of the body. A CT
scan shows detailed images of any part of the body, including the bones,
muscles, fat, and organs. CT scans are more detailed than general X-rays.

 Electroencephalogram (EEG). A procedure that records the brain's continuous,

electrical activity by means of electrodes attached to the scalp.

 Magnetic resonance imaging (MRI). A diagnostic procedure that uses a

combination of large magnets, radiofrequencies, and a computer to produce
detailed images of organs and structures within the body.