Head Injury

Initial assessment - GCS, C-spine injury, and Focal neurological deficit.

Examination:

• GCS

• Pupil size + reactivity to light - indicates raised ICP is unequal and unreactive to light

• Signs of head trauma

• Signs of Basal Skull Fracture (e.g. CSF ottorhoea/rhinorrhoea, periorbital ecchymosis i.e. raccoon eyes)

• Neuro exam

Indications for a CT Head within 1 hr/8 hrs:

Complications

• Early - Extradural/Subdural haemorrhage, Seizures

• Late - Subdural haemorrhage, Seizures, Diabetes Insipidus (Central), Parkinsonism, Dementia

Indicators of a Poor Prognosis

• Elderly

• Decorticate/Decerebrate posturing (Sign of severe brain damage), Extensor spasms, Prolonged coma