Head Trauma (Archived)

Excerpt

Head trauma is a common presentation in emergency departments, which accounts for more than one million visits annually. This is the leading cause of morbidity, disability, and mortality across all ages. Annually, almost 50 million people sustain head trauma. This burdens the health economy heavily, particularly in low-income nations.

Classification of head trauma based on severity

1. Mild (GCS 13 to 15)

2. Moderate (GCS 9 to 12)

3. Severe (GCS 3 to 8)

Classification of head trauma based on morphology

1. Diffuse-diffuse axonal injury (DAI), hypoxic brain injury, diffuse cerebral edema

2. Focal-contusions, hematomas, and

3. Fractures

Patterns of progression of head trauma

1. Primary insult-concussion, skull fracture, contusions, hematomas, subarachnoid hemorrhage

2. Secondary insult- complex cascades of events that follow the primary injury, such as cerebral edema, hematoma progression, seizures, ischemia, hydrocephalus, and vasospasm.

Pathoanatomic classifications of head trauma

1. Skull fracture

2. Epidural hematoma

3. Subdural hematoma

4. Subarachnoid hemorrhage (SAH)

5. Brain contusion

6. Intraparenchymal hemorrhage

7. Intraventricular hemorrhage

8. Diffuse axonal injury