concussion is a brain injury, caused by what?
sudden blow to the head
contusion is what?
a cerebral bruise, acceleration-deceleration injury
what are some cognitive problems that can occur because of a traumatic brain injury
putting it all together
a localized collection of extracasated blood trapped in an organ, space, or tissue. resulting from a break in the wall of a blood vessel
how does a hematoma develop
first a vascular injury occurs that creates bleeding
what three places in the brain itself can bleeding from a hematoma occur
epidural, subdural, and subarachnoid
a bleed from a hematoma that occurs in the brain are called
what kind of hematoma develops in the area between the DURA and the ARACHNOID (subdural space) and usually is the result of a tear in the small bridging veins that connect veins on the surface of the cortex to dural sinuses?
what kind of hematoma develops between the inner table of the bones of the skull and the dura, usually a result in an artery
what artery is usually tworn in a patient who has a epidural hematoma
middle meningeal, usually because of a skull fracture
how are subdural hematomas classified? what is it based on?
acute, sub-acute and chronic, based on approximate time before the appearance of symptoms
an acute subdural is seen within how many hours? why are these so dangerous
so dangerous because they progress rapidly and have a high mortality rate
why do acute subdural hematoma have a high mortality rate
secondary injuries related to edema and increased intracranial pressure
Sub acute subdural hematomas do not produce symptoms until how many days after
what can happen when a patient has a sub acute hematoma
symptoms can improve such as LOC and nurologic symptoms, but if the hematoma is not removed deterioration can happen
chronic subdural hematomas symptoms occur when?
several weeks after injury
what kind of patients usually have chronic subdural hematomas....why?
brain atrophy causes the brain to shrink away from the dura dn stretch fragile bridging veins, these veins rupture causing slow seepage of blood into the subdural space
epidural hematomas usually occurs in what kind of patients? why?
dura is less firmly attached to the skull surface than in an older person
what complications can an epidural hematoma cause
the dura can be easily separated from the inner surface of the skull, allowing the hematoma to GROW
how can a nurse tell if a patient might of had an epidural hematoma
hx of head injury and a brief period of unconsciousness, followed by a lucid period in which consciousness is regained, followed by a rapid progression to unconsciousness
what can happen if a hamatoma is not removed
increased ICP--> tentotrail herniation--> DEATH
when is the prognosis the best for an epidural hematoma
if the hematoma is removed before loss of consciousness
what is the primary treatment for a hematoma
decrease intracranial pressure
return blood flow