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Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
Chapter 254. Head Trauma in Adults and Children
Sections: Head Trauma in Adults and Children: Introduction, Epidemiology, Anatomy, Pathophysiology, Moderate and Severe Traumatic Brain Injury, Mild Traumatic Brain Injury and Sports-Induced Concussion, Special Considerations, Acknowledgments, References.
Topics Discussed: craniocerebral trauma.
Excerpt:"Traumatic brain injury (TBI) is defined as impairment in brain
function as a result of mechanical force. The dysfunction can be
temporary or permanent, and may or may not result in underlying
structural changes in the brain. The clinical severity ranges from
very mild (dazed or momentarily stunned) to profoundly impaired
(unresponsive, comatose). TBI is classified based on the clinical
assessment of a patient's level of consciousness with little
or no regard to the actual underlying injury. Therefore,
patients with the same TBI severity classification may have a dramatically different
pathophysiology (Figure 254-1). The current
classification system, based on the Glasgow Coma Scale (GCS), divides
TBI into severe (GCS score of 3 to 8), moderate (GCS score of 9
to 13), and mild (GCS score of 14 or 15) TBI. Mild TBI makes up
a majority of head injuries in the U.S. (approximately 80%).1 Moderate
TBI accounts for approximately 10% of head injuries. Mortality
rates for patients with isolated moderate TBI is <20%,
but long-term disability is as high as 50%. Overall, 40% of
patients with moderate TBI have an abnormal finding on CT scan and
8% require neurosurgical intervention.2 In severe
TBI mortality..."
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