Types of Head Trauma (Nursing)

00:00 Hi, welcome to our video series on Traumatic Brain Injury Types.

00:05 We're going to talk about the neurological disorders that go along with traumatic brain injuries.

00:09 Now we're going to start again with a definition.

00:11 A TBI or a traumatic brain injury is a traumatic insult to the brain that causes a change in the person's physical, emotional, social, or vocational abilities, and health.

00:24 Okay, that's a long list.

00:26 But keep in mind, a traumatic brain injury might change all of those areas of a patient's life, their physical abilities, their emotional health.

00:35 They may become very emotionally labile with big mood swings.

00:39 They may have difficulties in social situations.

00:41 They might not be able to read social cues anymore.

00:44 They might have a hard time going back to their job that they did before the traumatic brain injury, and then it can also impact their overall health.

00:52 So, traumatic brain injury is no small thing, not for the patient or for the people who care for and loved the patient.

01:01 So let's start with a pretty basic beginning.

01:04 We're gonna talk about an open versus a closed head injury.

01:08 Well, you see you there, that's a baseball bat attacking that head.

01:12 So, we're gonna look at closed head injuries first.

01:15 That's when the head strikes a hard surface or something strikes the head, like, for example, the baseball bat hitting the skull Now the dura stays intact.

01:25 No brain tissues exposed to the environment, but it's definitely come into contact with something violently traumatic.

01:32 That's a closed head injury.

01:34 The dura is intact, there's been an injury, but no brain tissue is exposed to the environment.

01:40 Now in an open head injury, you definitely have an opening in the scalp, the skull, and the meninges or brain tissue are exposed to the environment.

01:49 So that's basically the difference between a closed head injury and an open head injury.

01:55 In an open head injury, you have an opening where the meninges or the brain tissue are exposed to the environment.

02:00 This patient has an incredibly high risk for infection because now we have an open route from the outside environment and whatever they were exposed to to go directly to the layers of the brain.

02:13 Okay. So we've got open and closed.

02:16 Now let's take a look about the initial injury because in head trauma, there's an initial injury, and then there can also be secondary injury.

02:23 So, let's unpack initial injury first.

02:26 There's skull fractures where you've just got type of break in the skull.

02:30 Concussions, now this can be widespread brain trauma and a lot of times with concussions, you may not see an external sign of what the patient has experienced inside their skull.

02:41 But it's a widespread brain trauma due to a blow to the head, it also can happen if someone is shaken violently like as in shaken baby syndrome or any type of similar injury.

02:52 So concussions are widespread brain trauma, from a blow to the head from being shaken or from some injury that's similar to that.

03:00 A contusion is a brain bruise.

03:03 You got some bleeding on the brain and you end up just like if you had bumped your leg and you saw a bruise on your thigh.

03:08 A contusion involves brain bruising.

03:12 Now tensile stress and compression or shearing are the last ones that we'll talk about.

03:17 So the initial injury is what happens at the event, the time of the trauma.

03:22 Secondary injury is a complication from one of those in the column of initial injury.

03:28 So, these are things that happen because the patient experienced a skull fracture or a contusion, or a compression, or a shearing injury.

03:36 So that's what a secondary injury is.

03:38 They might have an epidural, subdural, or intra cerebral hematoma.

03:44 That means bleeding.

03:45 So, when you hear us talk about, "Oh, this patient had an epidural," that could either mean some type of anesthesia or if we're talking about a head injury that an epidural bleed, they're talking about the location of the bleed between the layers that protect the brain.

03:59 So, epidural and subdural refer to the layers of where that bleed is really located.

04:06 Intracerebral could be right in the mid, the tissue of the brain, and hematoma just means that bleeding or that bruising.