Brain injury: Difference between revisions
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:"headache, vomiting, an age over 60 years, drug or alcohol intoxication, deficits in short-term memory, physical evidence of trauma above the clavicles, and seizure" | :"headache, vomiting, an age over 60 years, drug or alcohol intoxication, deficits in short-term memory, physical evidence of trauma above the clavicles, and seizure" | ||
[[X-ray]] of the cervical spine should be considered, especially if the patient fulfills criteria from the Canadian C-Spine Rule [[clinical prediction rule]] for [[neck]] | [[X-ray]] of the cervical spine should be considered, especially if the patient fulfills criteria from the Canadian C-Spine Rule [[clinical prediction rule]] for [[neck injury]]: <ref name="pmid14695411">{{cite journal |author=Stiell IG, Clement CM, McKnight RD, ''et al'' |title=The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma |journal=N. Engl. J. Med. |volume=349 |issue=26 |pages=2510–8 |year=2003 |month=December |pmid=14695411 |doi=10.1056/NEJMoa031375 |url=http://content.nejm.org/cgi/pmidlookup?view=short&pmid=14695411&promo=ONFLNS19 |issn=}}</ref> | ||
* Age 65 years or more | * Age 65 years or more | ||
* [[Paresthesia]]s in extremities | * [[Paresthesia]]s in extremities | ||
Revision as of 00:51, 9 February 2009
In medicine, brain injuries are "acute and chronic injuries to the brain, including the cerebral hemispheres, cerebellum, and brain stem. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with diffuse axonal injury or coma, post-traumatic. Localized injuries may be associated with neurobehavioral manifestations; hemiparesis, or other focal neurologic deficits.."[1]
Types of brain injury include brain concussion.
Diagnosis
X-ray computed tomography of the head should be considered, especially if the patient fulfills any criteria from the New Orleans Criteria clinical prediction rule:[2]
- "headache, vomiting, an age over 60 years, drug or alcohol intoxication, deficits in short-term memory, physical evidence of trauma above the clavicles, and seizure"
X-ray of the cervical spine should be considered, especially if the patient fulfills criteria from the Canadian C-Spine Rule clinical prediction rule for neck injury: [3]
- Age 65 years or more
- Paresthesias in extremities
- Dangerous fall ("elevation >=3 ft or 5 stairs; an axial load to the head (e.g., diving); a motor vehicle collision at high speed (>100 km/hr) or with rollover or ejection; a collision involving a motorized recreational vehicle; or a bicycle collision")
- Inability to rotate the neck 45° to the right and left
- Only test if "simple rear-end motor vehicle collision, sitting position in ED, ambulatory at any time since injury, delayed onset of neck pain, or absence of midline C-spine tenderness"[4]
- Glasgow Coma Scale less than 15 (the Canadian C-Spine Rule was only designed for alert patients)
Treatment
Mild injury may not benefit from multidisciplinary[5] or rehabilitation[6] treatment.
References
- ↑ Anonymous (2024), Brain injury (English). Medical Subject Headings. U.S. National Library of Medicine.
- ↑ Haydel MJ, Preston CA, Mills TJ, Luber S, Blaudeau E, DeBlieux PM (July 2000). "Indications for computed tomography in patients with minor head injury". N. Engl. J. Med. 343 (2): 100–5. PMID 10891517. [e]
- ↑ Stiell IG, Clement CM, McKnight RD, et al (December 2003). "The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma". N. Engl. J. Med. 349 (26): 2510–8. DOI:10.1056/NEJMoa031375. PMID 14695411. Research Blogging.
- ↑ Stiell IG, Wells GA, Vandemheen KL, et al (October 2001). "The Canadian C-spine rule for radiography in alert and stable trauma patients". JAMA 286 (15): 1841–8. PMID 11597285. [e]
- ↑ Ghaffar O, McCullagh S, Ouchterlony D, Feinstein A (August 2006). "Randomized treatment trial in mild traumatic brain injury". J Psychosom Res 61 (2): 153–60. DOI:10.1016/j.jpsychores.2005.07.018. PMID 16880017. Research Blogging.
- ↑ Elgmark Andersson E, Emanuelson I, Björklund R, Stålhammar DA (February 2007). "Mild traumatic brain injuries: the impact of early intervention on late sequelae. A randomized controlled trial". Acta Neurochir (Wien) 149 (2): 151–9; discussion 160. DOI:10.1007/s00701-006-1082-0. PMID 17252176. Research Blogging.