Head Injuries

6 Pages 1566 Words

Head injuries are some of the most difficult injuries to manage in the pre-hospital setting. Head injuries account for about twenty five percent of trauma deaths and are a direct result of a force exerted on the skull and/or brain (Campbell 114). There are many types of head injuries divided into several categories: primary brain injuries, secondary brain injuries, concussions, cerebral contusions and structural injuries to the skull and scalp. All significant head injuries should be managed aggressively in the pre-hospital setting to provide the patient with the best clinical outcome.
Primary brain injuries are a result of the initial damage to the brain tissue and a result of the force of the injuries (Campbell 115). Types of primary brain injuries include: gun shot wounds that penetrate the brain, depressing skull fractures that displace brain matter and any trauma to the head that results in the brain striking the inside of the skull. Common causes of primary brain injuries include rapid deceleration injuries such as head on motor vehicle collisions were the patient’s head strikes the windshield and the brain continues to travel forward and strikes the inside of the skull, this is known as “coup injuries”. The brain can also rebound and strike the opposite side of the skull, this type of impact is known as “contracoup injury” (Campbell 115). Early and proper management of primary brain injuries including rapid transport to a qualified trauma center can prevent the progression to secondary brain injuries.
Secondary brain injuries are caused by the body’s natural response to the primary insult (Campbell 115). Contributing factors to secondary brain injuries include: hypotension, decreased profusion to brain, hypoxia and fluid accumulation in the intracranial space. As with other tissues in the body, when struck with significant force the tissues swell as part of the inflammatory process. The main problem bei...