There are many signs to detects increasing of Intercranial tension:
:vomiting is a good sign of increase intercranial tension after head trauma especially ifbrain concussion is present.
:at first there is a sluggish reaction to light then it progress to no reaction and this stagecalled (dilated fixed pupils).#the main problem of increase intercranial tension is a compression on cranial nerves.
Exposure and environmental control
All of the victim's clothing is removed to permit full assessment and exclude other injuries.
Control and Prevention of infection
1. clean the wound by running saline.2. Do not cut the tissues spontaneously specially in the face.3. close the wound as soon as possible under local anesthesia if necessary.4. antibiotic course.
This can be severe particularly with comminuted and grossly displaced fractures, and should beused but not Morphine or its derivatives because they may mask the signs of increasing intracranialPressure as will as its side effect(addiction) so Non-steroidal anti-inflammatory drugs may beprescribed.
to facilitate understand the fractureand concept on fracture displacement and factor affect on it:
For describing injuries the face is divided into three parts. The lower third is the mandible and thesoft tissues covering it , The middle third , The upper third lies above this.
Muscles attaches to mandible are :1. posteriorly
lateral ptregoid muscle to condyle
medial ptregoid muscle to medial surface of angle &ramus of mandible
massetar muscle to lateral surface of angle
temporalis muscle to coronoid processThese muscles pull the mandible anteriorly and inward.
head injury may cause brain concussion and this result ofacceleration & deceleration and this patient should be under close observationhourly through 24 houres.