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Nervous System Trauma
Define these terms
- Head Injury
- Traumatic Brain Injury
- Cerebral Concussion
- Diffuse Axonal Shearing Injury
- Whiplash injury
- Myofascial Injury
- Traumatic Intracranial Hemorrhage
- Lucid Interval
Discussion: for Case Studies (below)
A. What has happened to this patient?
B. Your assessment of appropriateness of evaluation.
C. What is the mechanism of the neurological impairment?
D. What is the natural history and appropriate management?
- 35 year-old white male is rear-ended in his red Ferrari convertible by a pick-up truck. His head hits the steering wheel. He develops a bruise on the frontal region. He has no LOC or amnesia. He demands to be taken to the local ED where skull and cervical spine x-rays, brain and cervical spine CT and MM, EEG, and EEG are done. He calls his attorney to file a five million dollar lawsuit for "irreversible brain injury."
- 35 year-old white female psychic falls and strikes her head in local restaurant. She is slightly "dazed" for 10 minutes and has no memory of the fall. She has headache, dizziness and neck pain. She takes OTC medication, but the headache persists for 2 weeks; she later, reports she has lost her psychic powers. She reports persistent visual blurring when reading, fight-headedness, difficulty concentrating, poor memory, and difficulty sleeping. Six months later her symptoms are not improved. She sues for loss of psychic powers and is awarded two million dollars.
- 8 year-old boy falls off a swing and hits his head. He has LOC for 5 minutes and is dazed for one hour. At this time he is neurologically asymptomatic. Skull radiogram is normal and he is discharged to his parents' care with instructions to return if he develops any neurological disturbance. Six hours later he vomits, becomes confused, and the left pupil dilates.