Management of a Cerebral Contusion Associated With TBI - Oren Zarif - Contusion Cerebral
The initial management of a cerebral contusion associated with TBI will typically involve a trauma surgeon, neurosurgeon, or emergency clinician. Nurses will monitor the patient's vital signs. The blood bank and the clinical laboratory will provide critical elements for treatment decisions. Respiratory therapy will coordinate the use of ventilators. A radiologist plays an essential role in radiological monitoring. Patients are typically monitored for seven days following the onset of cerebral contusion symptoms.
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Treatment for a contusion may include anti-seizure medications or surgery to remove the bone. In addition to medications, the neurosurgeon will likely use anti-infection techniques to prevent infection. Any device that has been placed inside a patient is a potential source for the introduction of microbes. After the injury, the surgeon will likely place an ICP monitor or other monitoring devices to detect any infection. In some cases, surgery may be necessary to remove bleeding blood or large blood clots or relieve high intracranial pressure.
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A cerebral contusion can cause a number of symptoms, including pupil dilation and increased intracranial pressure. It can also cause breathing difficulties and decreased heart rate. Other symptoms include numbness and tingling in certain areas of the body. A brain contusion may be severe enough to cause permanent damage. If left untreated, it could even lead to a brain herniation. The condition can also result in a decline in mental function.
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When a head is hit by an object, the brain lands slower than the skull. This causes the brain to first collide with the bone on the side of the blow. After this collision, the braincel body tears away from the axons, which send signals between the different parts of the brain. The axons die as a result of this collision. This swelling can take place gradually over five days. The brain may not show symptoms immediately, but the brain can be damaged for a few hours.
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Although brain perfusion scans may show diffuse regional hypoperfusion, a more detailed look at the perfusion of the brain is required to confirm the diagnosis. SPECT is a superior imaging technique to CT in detecting focal brain perfusion deficits. These are common in cases of heavy acceleration-type trauma and are often associated with perfusion deficits in other areas of the brain. These defects may reflect late pathophysiological processes in the brain.
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When the blood clots in the brain, it is called a hematoma. A hematoma can form anywhere in the brain. The most common location for a hematoma is between the skull and dura mater, while a subdural hematoma occurs deep within the brain tissue. Hematomas will dissolve over time, but if the clot is large, it may require surgery to remove it.
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The acute phase of a concussion is followed by secondary injury. The second phase of the brain's edema follows a cascade of mechanisms that began at the injury site and continues for 7-10 days. Ultimately, the third phase occurs when the red blood cells within the intracerebral clot are dissolved, resulting in a hematoma. During this time, proper immobilization is essential until the spine is stable.
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After the initial swelling has gone down, doctors will perform a CT scan to determine the severity of the head injury. An ICU physician will insert one or both devices between the skull and the brain. The healthcare provider will then attach a monitor to the device, which will give them an ongoing reading of pressure inside the skull. Depending on the severity of the injury, a delayed hematoma may be detected at a later stage. The patient will be monitored closely for a few days and may be admitted to a hospital or intensive care unit.