Predisposing Factors: Precipitating Factors:

 Age: (16-30 years

old)  MVA (46%)
29 yrs old  Falls (22%)
 Gender: (Male:
54%, Female:
46%)
Female

Head injury

CT scan:
 Right parietal, temporal S/Sx:
and sphenoid bone  Decreased Hbg, Hct,
fractures Skull fracture & Direct cell MCV, MCH, MCHC
 Frontotemporoparietal Breakdown BBB damage  Restlessness
convexities  Irregular breathing

Medical mngt: Leakage of CSF Activation of

 Emergency & blood Inflammatory
craniectomy
Mediators

Ketorolac Vascular
Tramadol disruptions
Ranitidine Increase of
Cerebral Blood
Flow
Rupture of small
blood vessels in
Subdural space
Inflammation Paracetamol

Tranexamic Bleeding &

Acid Hemorrhage Mannitol
Cerebral edema
Citicholine
Furosemide

CT scan:
Acute Formation of
subdural blood clots
hematoma

Nsg Dx:
Risk for ineffective
Increased cerebral tissue perfusion
intracranial pressure r/t increase ICP
secondary to brain injury
 Monro-Kellie Hypothesis
Compensation: CSF, Blood, Brain Tissue

Reduction of Cerebral Brain Tissue

Blood Flow compensates

CT scan:
Cerebral Hypoxia S/Sx:
Right
Brain herniation  Stupor
Subfalcine
herniation  Seizure

Ischemia
Compression of Brain Levetiracetam
stem

Medulla
Nerve pathway Midbrain is Pons
oblongata is
between brain & affected involvement
affected
spinal cord is
damaged

Visual & Maintenance

Dysfunction
auditory of
of visceral
Abnormal positioning processing consciousness
organs
Loss of fine movements dysfunction is altered
in arms, hands & fingers

S/Sx: S/Sx:
S/Sx: S/Sx:  Vegetative  Decreased RR
 Decerebrated  Unresponsive state  Difficulty breathing
limbs pupil  Coma  Decreased
 Little peristalsis
movements in  Constipation
fingers Nsg Dx:  Decreased HR
 Paraplegic Risk for impaired skin integrity r/t
prolonged immobility
Medical mngt:
 Mechanical
Nsg Dx: Nsg Dx:
ventilation
Impaired physical mobility r/t motor Risk for aspiration r/t presence
neural impairment secondary to of ETT secondary to increase  Insertion of ETT &
subdural hematoma mucous secretions NGT