Neurotrauma

Question 1

Head injury?

Answer 1

Physical injuries to skull, facial fractures, soft tissue damage WITHOUT neurological consequences

Question 2

Brain injury

Answer 2

Physical injuries to skull, facial fractures, soft tissue damage WITH neurological consequences

Question 3

Klasifikasi head/brain injury (3)

Answer 3

-mekanisme
-severity
-morphologi

Question 4

Klasifikasi head/brain injury: mekanisme?

Answer 4

-tumpul
-penetrasi

berdasarkan ada tidaknya penetrasi duramater

Question 5

Klasifikasi head/brain injury: severity?

Answer 5

Mild GCS 14-15
Moderate GCS 9-13
Severe GCS 3-8

Question 6

Klasifikasi head/brain injury: morfologi?

Answer 6

1. Skull fracture
   - Vault (linier/satelite, depressed/non, open/close)
   -basilar (w/ or w/o CSF leakage, w/ or w/o N.VIII palsy)
2. Intracranial lesion
   -Focal (vascular injury EDH,SDH,ICH; axonal injury, contusion, laceration
   -Diffuse (axonal injury: classic concussion, vascular injury: multiple small hemorrhage)

Question 7

Cidera kepala -> cidera otak mechanism (5)

Answer 7

-direct impact
-acceleration-deceleration
-shockwaves
-cavitation effect
-angular force

Question 8

Cedera otak sekunder?

Answer 8

Diffuse hypoxic-ischemic, brain swelling
Focal hypoxic-ischemic, brain swelling

Question 9

Langkah tatalaksana cedera otak di RGD

Answer 9

1. General precaution
2. Stabilisasi Airway, Breathing, Circulation
3. Survey sekunder (pemeriksaan status general terdiri dari anamnesa dan pemeriksaan fisik seluruh sistem organ)
4. Pemeriksaan neurologis
5. Menentukan diagnosis klinis dan pemeriksaan tambahan
6. Menentukan tahapan tatalaksana selanjutnya sesuai buku Pedoman

Question 10

Neurotrauma pemeriksaan umum?

Answer 10

Dari ujung rambut -> kaki
Per sistem organ B1-b6

Question 11

Px neurologis pada neurotrauma (2)

Answer 11

GCS
Saraf kranial:
-Pupil, bentuk, reflek cahaya
-Motor-sensor
-Otonom: reflek bulbocavernosa, cremaster, sfingter

Question 12

ICP formula

Answer 12

ICP = MAP-CPP

Question 13

Normal ICP

Answer 13

10-15 mmHg

Question 14

Severe increased ICP

Answer 14

> 41mmHg

Question 15

Optimum CPP and MAP

Answer 15

CPP >70mmHg
MAP > 90mmHg

Question 16

Monro kellie doctrine

Answer 16

Vblood + Vcsf + Vparenchyma = ICV