Traumatic Brain Injury Part II
Part 2: Secondary Brain Injury
Summary
Mortality and morbidity after a head injury are influenced by both primary and secondary damage. While there is no effective treatment for primary brain damage, prevention and/or effective treatment of secondary insults to the brain are the key issues in treatment.
Having ascertained the severity of brain injury at the earliest possible opportunity, this is the best guide to the extent of primary brain injury which has resulted from the direct mechanical trauma at the scene of the accident. We have discussed how this may be achieved clinically using the Glasgow Coma Scale and we shall examine additional methods later in this Task. Changes in these parameters with time may assist you in detecting secondary brain injury, determining the effects of treatment and predicting outcome.
General Information
Enrolled trainees 2166
Open 03.05.2019
Available for ESICM members
Student effort 3
Last Updated August 8, 2022
Intended Learning Outcomes
At the end of the Unit the student should able to:
- Define secondary brain injury
- Describe the difference between primary to secondary brain injury
- Recognise the extra-cranial and intra-cranial causes of secondary brain insults
- Describe image findings of intra-cerebral lesions and consequences in TBI patients including: Mass effect, Focal lesions, Skull fractures, tSAH, Epidural hematoma, Subdural hematoma, and Traumatic contusion/laceration and intracerebral hematoma
Relevant competencies in CoBaTrICE
- 2.2 Undertakes timely and appropriate investigations
- 2.8 Liaises with radiologists to organise and interpret clinical imaging
- 2.9 Monitors and responds to trends in physiological variables
- 2.10 Integrates clinical findings with laboratory investigations to form a differential diagnosis
- 3.6 Recognises and manages the patient with neurological impairment
- 4.4 Uses fluids and vasoactive / inotropic drugs to support the circulation
- 6.3 Manages the care of the patient following craniotomy under supervision
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