PATHOPHYSIOLOGY

Legend:
Manifested by the patient - *
Signs and Symptoms
Disease flow
Predisposing Factors
Male *
>30 years old *

Precipitating Factors
Motor vehicular accident
* Alcohol related accident
* Assault
Falls
Substance Abuse

Sudden impact force to

the head/inertia forces
within the skull

Direct impact to
the brain

Primary injury

Scalp injuries *

Minor

Abrasions *
Minor bleeding
Minor cuts

No direct damage
beneath the contact site
Does not require
hospitalization
Treatment of external
injuries are only required
Good prognosis

Bleeding *
Tissue injury *
edema

Lacerations *
Hematomas
Contusions
Abrasions to the skin *
Bleeding *

Major

Profuse bleeding
Loss of
consciousness
Seizures
Vomiting

Damage beneath
the contact site
Continuing injury
Secondary injury

Profuse bleeding
Loss of
consciousness
Seizures
Vomiting

With Interventions
Medical interventions:
Diagnostics:
MRI
CT-Scan
X-ray
Drugs:
Diuretics
Management:
Craniotomy
Breathing support
Management of fluid intake
Management of nutritional
and gastrointestinal function.
Nursing Interventions:
Monitor patients neurologic
status, ICP and vital signs at least
every hour.
Maintain patients head of the
bed at 30 degrees elevation or
higher and patients body in a
neutral position. Do not allow
pronounced neck or hip flexion.
Suctioning as needed
Maintain patients head of the
bed at 30 degrees elevation or
higher and patients body in a
neutral position.
Monitor the patients
temperature
Calculate the mean arterial
pressure (MAP) and the CPP.
Assure proper placement of a
feeding tube and assess
gastrointestinal functioning prior
to and during feeding.
Turn patient side to side q 2
hours to prevent decubitus
ulcers.
Provide NGT feeding as ordered.
Suctioning as needed.
Increased Intracranial Pressure lowered
and maintained.
Patient resumes activities of daily living
Good Prognosis

Without Interventions

Increased Intracranial
Pressure
Brain become hypoxic
Less oxygen to the
Brain
Brain Hypoxia
Ischemia
Brain Death
Bad Prognosis
Death