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EMERGENCY ACTION PLAN On-person equipment On-site equipment Communication Mock up!. COVERINGS OF BRAIN. Epidural Space. Subdural Space. Subarachnoid Space. SPACES AND CONTENTS. Epidural Space - Arteries. Subdural Space - Veins. Cerebrospinal Fluid. MAJOR STRUCTURES WITHIN SPACES.
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EMERGENCY ACTION PLAN On-person equipment On-site equipment Communication Mock up!
Epidural Space Subdural Space Subarachnoid Space
SPACES AND CONTENTS EpiduralSpace - Arteries Subdural Space - Veins Cerebrospinal Fluid
MAJOR STRUCTURES WITHIN SPACES. Epidural space – Arteries Subdural Space – Veins Subarachnoid Space – Cerebrospinal Fluid (CSF)
DURA Arachnoid
General Comments Relating to Concussions Caused by direct force to the head or by ‘impulsive’ force transmitted to the head.
General Comments Relating to Concussions Rapid onset of short-lived impairment of neural function. Acute clinical symptoms are functional, not structural in nature.
General Comments Relating to Concussions May or may not involve loss of consciousness. Is typically associated with grossly normal structural imaging study.
ANGULAR FORCE
TRANSLATIONAL FORCE
Acceleration-Deceleration Injury Translation
A B
B A A. Head Hits Object. B. Brain Rebounds
1. Reticular Activating System 2. Cerebral Cortex 3. Brain Stem
Brain Damage FOCAL – can be seen by the trained eye. DIFFUSE – can not be seen by the trained eye.
Thickness of skull. • Magnitude and direction of impact • Size of impact area
(signs and symptoms) • Visible deformity • Deep laceration • Depression/ crepitus • Discolouration • CSF from ears or nose
Battle’s Sign • Raccoon Eyes • Halo Sign
INTRACEREBRAL BLEED Focal injury involving small bleeds in the cortex, brain stem or cerebellum. Usually caused by a bruise as a result of the head stopping movement and the brain continues moving.
very rare in sports. • direct blow to side of head. • Middle Meningeal A. is severed. 1
May have initial L.O.C. from blow. • Regain and ‘normal’. • 10-20 min. decline. • Headache, vomiting, drowsiness. 2
Decrease consciousness. • Dilate pupil on side of bleed. • Opposite side weakness. • Emergency……. Fatal 3
Caused by acceleration of the head rather than impact. • Three times more frequent than epidural. • Bleed under dura. 1
(Signs & Sym.) • Low pressure venous bleeding clots slowly. • S&S may become evident for hours, days, weeks. • Sometimes accompanied by cerebral swelling. 2
(S&S of Increasing Pressure) Severe headache–Nauseaor vomiting–Confusion or Impairment of Consciousness-Rising B.P.–Falling Pulse–Changes in Emotion–C.N. problems (eye tracking). 3
CEREBRAL CONCUSSION Criteria for Severity Consciousness Mental Confusion Memory Loss Tinnitus Unsteadiness
Posttraumatic Amnesia Retrograde Amnesia Anterograde Amnesia R. Cantu.. Journal of Athletic Training. Sept/01
RETROGRADE AMNESIA “ partial or total loss of the ability to recall events that have occurred during the period immediately preceding brain injury.”
ANTEROGRADE AMNESIA “ a deficit in forming new memory after the accident, which may lead to decreased attention and inaccurate perception.”