4 Neurologic Injury in Trauma Free Online FlashCards

How do primary and secondary injury differ?

Primary injury is damage from the initial impact; secondary injury is additional damage that develops afterward, such as from hypoxia, hypotension, swelling, or impaired perfusion.

Why repeat and document neurologic examinations?

Establish a baseline neurologic examination as early as the patient’s condition permits, then repeat and document it to identify changes. Note limitations such as sedation, intoxication, or distracting injuries.

Which three responses make up the Glasgow Coma Scale?

The Glasgow Coma Scale assesses eye opening, verbal response, and motor response.

Why record individual GCS components?

Record each GCS component, not only the total, because changes in an individual component—especially the motor response—can be clinically important.

What GCS ranges are commonly grouped as mild, moderate, and severe?

GCS scores of 13–15 are commonly grouped as mild, 9–12 as moderate, and 8 or less as severe injury. These categories do not fully measure injury severity.

What can a new unequal or unreactive pupil signal after TBI?

New pupillary asymmetry or a newly unreactive pupil may signal brainstem compression and impending herniation; it requires urgent reassessment and escalation.

Which changes can indicate neurologic deterioration after trauma?

A falling GCS or motor response, new weakness, repeated vomiting, seizure, worsening headache, unequal pupils, or declining responsiveness are concerning. Reassess promptly and escalate rather than assuming the cause.

What monitored ICP value is recommended as a treatment threshold in severe TBI?

When ICP is monitored in severe TBI, the Brain Trauma Foundation recommends treating values above 22 mm Hg. Interpret the value alongside examination and CT findings.

Which priorities help prevent secondary brain injury?

Prevent secondary brain injury by maintaining oxygenation and adequate circulation, avoiding hypotension, preventing fever, and monitoring ventilation.

What findings after trauma raise concern for spinal cord injury?

Suspect SCI after trauma when there is weakness, unequal movement, sensory loss, loss of muscle tone, or new bowel or bladder dysfunction.

Why is a high cervical SCI an immediate respiratory concern?

A high cervical spinal cord injury may impair breathing. During the primary survey, check gross motor function and sensation while addressing life threats; do not delay urgent resuscitation for a detailed examination.

What is the purpose of the ISNCSCI examination?

ISNCSCI provides a structured examination and classification of spinal cord injury. Trained clinicians use it to determine neurologic level and injury classification.