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.

Choice Treatment for sciatic nerve injury

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Pressure Stocking Detects Neuropathic Injury Points

Today's post from diabetes.co.uk (see link below) covers something we've mentioned earlier on the blog and that is a new commercial stocking/sock which will sense when undue pressure is being put on certain areas of the feet and will hopefully prevent pressure sores and worse for people with severe numbness in their feet. it looks as though it's going to be costly, maybe too costly for the individual neuropathy sufferer but hopefully it will be introduced into insurance coverage packages and thus be available for those who need them. The question is, do you need something like this? Most neuropathy sufferers don't have total loss of feeling in their feet - having numbness in the pads of the feet but generally retaining some sort of feeling to detect the ground under their feet. This will be useful for those unfortunate people who have lost all feeling and are therefore at serious risk of undetected injury. An interesting development - worth a read.

New pressure-monitoring device could prevent neuropathy-related injuries
Kurt Wood Thu, 14 May 2015


Researchers from Germany have developed a pressure-monitoring stocking that could prevent foot wounds in people with diabetic neuropathy.

The device, which was developed by researchers at the Fraunhofer Institute for Silicate Research ISC in Würzburg, uses integrated sensors to send warnings when pressure on the foot is too high, essentially performing the job of the nerves in the feet.
Neuropathy and foot pressure Diabetic neuropathy is one of the most common diabetic complications. Over time, prolonged exposure to high blood glucose levels damages the nerves in the feet. Diabetic neuropathy is the leading cause of amputation in the UK.

When people develop diabetic neuropathy, they lose the feeling in their feet. This can have a number of damaging effects. One such effect is the inability to notice the amount of pressure being placed on the feet. People without diabetic neuropathy have functioning nerve pathways that automatically redistribute when the person is standing up for a long time.

Over time, excessive weight placed on the feet can lead to the development of pressure sores, which can in turn lead to open wounds or damaged foot tissue.
How does the pressure stocking work? The stocking features 40 dielectric elastomer sensors that measures pressure distribution. The sensors are made from a special silicone film. When pressure builds on the foot - usually because of standing in the same place for a while - the sensors transmit a signal to a wireless electronics unit.

The stocking will cost around £180. 

What makes the pressure stocking different? There are several products available to balance out pressure on the foot for people with diabetes, but this one is different, according to Dr. Bernhard Brunner, of the Fraunhofer institute:

"Existing systems on the market measure the pressure distribution only on the bottom of the foot using shoe inserts. Our sensors are attached to the stocking's sole, at the hell, the top of the foot and the ankle, so they can take readings in three dimensions. This is a totally new approach."
Moving forward The device is brand new, and some creases still to be ironed out. Dr. Brunner explained the challenges that face the team going forward:

"With the current prototype, the electronics are attached to the end of the stocking. We're planning to relocate them to a small, button-sized housing that can be detached with a hook-and-loop fastening strip. There's no way around this until a reliable method for cleaning the electronics is developed."

The sensors have to be washable, too. "The first washability tests are in planning, but cleaning using disinfectant is no problem."

The researchers have filed a patent application for the stockings. From May 19 to May 20, the team will be presenting a prototype of the stockings at the SENSOR+TEST 2015 Measurement Fair in Nuremberg.

http://www.diabetes.co.uk/News/2015/May/new-pressure-monitoring-device-could-prevent-neuropathy-related-injuries-97065315.html