HEAD INJURY DIAGNOSIS

DIAGNOSIS OF HEAD INJURY


The physical examination and also the history of the exact information on the injury are the first stages in caring for a patient with head trauma. The patient's past health background and medication usage may also be important factors in deciding the following steps. Plain skull X-rays are hardly ever done for the evaluation of head trauma. It is more important to evaluate brain function than to consider the bones that surround the mind. Plain X-ray films might be considered in infants to consider a fracture, based upon the clinical situation.
In some instances, further tests might be necessary to determine how serious your face injury is and regardless if you are at risk of developing any complications. The tests you'll need and how urgently you'll need them will depend on:
• your symptoms
• your GCS score
• your health background
• the circumstances of your injury
Tests that you might possibly need to have are described below.


Computerised tomography (CT) scan
A computerised tomography (CT) scan involves using a series of X-rays taken of the body at different angles. This creates a detailed image of within your body.
A CT scan may be used to examine the bone, muscle and tissue inside your neck, to check for just about any damage and to identify whether there's any bleeding or inflammation (swelling) inside your brain.


X-ray
An X-ray uses radiation to consider pictures of the bones within your body. An X-ray might not help diagnose a brain injury, however it can be used to check for any breaks or fractures inside your skull or other bones within your body.


Magnetic resonance imaging (MRI) scan
A magnetic resonance imaging (MRI) scan uses strong magnetic fields and radio waves to make a detailed image of within your body.
An MRI scan can measure alterations in blood flow in the brain and detect harm to the brain or spinal-cord.


Test results
Based on your test results, you might be allowed to go home, truly you will be kept in hospital for any short time. This is to ensure that your injury hasn't caused any serious problems.

The Ottawa CT head rules affect patients age 2 to 65.
High-risk
• Glasgow Coma Scale less than 15, 2 hours after injury
• Suspect open or depressed skull fracture
• Sign of basilar skull fracture
• Vomiting more often than once
• Older than 65 years old
Medium Risk
• Amnesia before impact more than 30 minutes
• Dangerous mechanism of damage


Head Injury Guidelines and  Head Injury   Glasgow Coma Scale

The Glasgow Coma Scale was created to provide a simple method for health care practitioners of different abilities and training to quickly assess a patient's mental status and depth of coma based on observations of eye opening, speech, and movement. Patients within the deepest level of coma:
• do not respond with any movement to pain,
• do have no speech, and
• do not open their eyes.
Those who work in lighter comas may offer some response, to the stage they may even seem awake, yet meet the requirements of coma because they do not react to their environment.


Glasgow Coma Scale

Eye Opening  
Spontaneous 4
To loud voice 3
To pain 2
None 1

Verbal Response  
Oriented 5
Confused, Disoriented 4
Inappropriate words 3
Incomprehensible words 2
None 1

Motor Response  
Obeys commands 6
Localizes pain 5
Withdraws from pain 4
Abnormal flexion posturing 3
Extensor posturing 2
None 1
Glasgow Coma Scale
An individual who is awake includes a Glasgow Coma Scale of 15, while an individual who is dead might have a score of three. The abnormal motor responses of flexion and extension describe arm and leg movement whenever a painful stimulus is used.
• The term "decorticate" (de=not + cortex=conscious part of the brain) refers back to the cortex of the brain, the part that are responsible for movement, sensation, and thinking.
• "Decerebrate" (de=not + cerebrum= brain and brainstem) implies that the cortex and the brain stem that unconsciously controls basic bodily processes like breathing and heartbeat, may not functioning.
Trauma patients in many cases are "touched" by many health care practitioners; from first responders, EMTs, emergency physicians, surgeons and neurosurgeons. It's not only important to assess the depth of coma but additionally to know if the patient is improving or deteriorating. The Glasgow Coma Scale allows that analysis to happen.
The scale is used included in the initial evaluation of the patient, but doesn't assist in making the diagnosis regarding the cause of coma. Since it "scores" the amount of coma, the GCS can be used as a typical method for any healthcare practitioner to assess alternation in patient status.