Traumatic Brain Injury Types

Neurological Disorders

With Rhonda Lawes

Hyale Leo, priorz.o.ne.86.6.2@gmail.com

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 Traumatic Brain Injury

TBI is a traumatic insult to the brain that

causes changes in a
emotional, social, or vocational abilities
and health.

Hyale Leo, priorz.o.ne.86.6.2@gmail.com

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 Open vs. Closed Head Injury
Closed head injury Open head injury

• Head strikes a hard surface or • Opening in the scalp, skull,

something strikes the head meninges or brain tissue
exposed to environment
• Dura is intact, no brain tissue
exposed to the environment • High risk of infection

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 Types of Head Trauma
Initial injury: Secondary injury:

• Skull fractures • Complications from initial injury

• Concussion widespread brain • Epidural, subdural, intracerebral

trauma due to a blow to the head, hematomas
shaking, or a similar injury

• Contusion includes bleeding on

the brain or a

• Tensile stress

• Compression, or shearing

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 Initial Acceleration Injury

Moving object strikes a non-moving head.

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 Initial Acceleration/Deceleration Injury

IMPACT IMPACT

Moving person comes to an abrupt stop.

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 Initial Coup-contrecoup Injury

Coup: Head hits windshield. Contrecoup: Brain injury on the

opposite side of the brain.
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 Acceleration/Deceleration Injuries

Tensile stress Compression Shearing

Over stretching and Increased amount of Diffuse axonal injury is

twisting of tissue pressure pushing on the the shearing/tearing of the
brain
nerve fibers)

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 Skull Fractures

Compound Displaced

Occurring with an open wound Closed wound, end of

fractures do not meet

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 Skull Fractures

Linear skull fractures

• Most common type

• Break in the bone, but it

does not move the bone

• Usually no intervention
necessary beyond
observation

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 Skull Fractures

Depressed skull fractures

• Bone pressed into the dura

• Often requires surgical

elevation of bone,
debridement, repair of dura

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 Skull Fractures

Diastatic skull fractures

• Most common in older

newborns and infants

•
suture lines and widens
them

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 Skull Fractures

Basilar skull fracture

• Most serious type of

skull fracture

• Involves a break in the

bone at the base of the
skull

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 Signs of Basilar Skull Fracture

Raccoon eyes Battle sign

Late sign of anterior fossa fracture Delayed sign of middle fossa fracture

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 CSF Leaks

• Cerebral spinal fluid leaks

• Watch for draining from nose or ears

• Otorrhea ear: middle fossa fracture

• Rhinorrhea nose: anterior fossa fracture

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 Is it CSF?
How can I be sure?

• Test for glucose in the fluid

CSF is 2/3 the level of the blood

• If mixed with blood: Halo test layering with

blood on inside and fluid on the outside

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 In a Nutshell

 A TBI is a traumatic insult to the brain that

emotional, social, or vocational abilities and

health.

 A head injury can be closed or open.

 Initial injury involves concussion, contusion,

skull fractures, compression, shearing and
tensile stress.

 Secondary injury involves complications

from the initial injury.

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 In a Nutshell

 Acceleration/deceleration injuries include

coup-contrecoup, shearing, and tensile
stress.

 Basilar skull fractures are the most serious

skull fracture and can become life-
threatening.

 Nurses should watch for leaking CSF, battle

sign, and raccoon eyes in head injury
patients.

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 This document is a property of: Hyale Leo

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