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Basics
Description
- A dynamic process with penetrating or blunt injury to the brain with initial bleeding followed by secondary injury due to cerebral edema and/or continued bleeding
- Frequently related to rapid deceleration, as in motor vehicle or diving accidents, or blunt trauma
- System(s) affected: Cardiovascular, Endocrine/Metabolic, Nervous
- Synonym(s): Head injury
Epidemiology
Incidence
- 1,365,000 hospital emergency room visits per year
- 275,000 hospitalizations/year
- 52,000 deaths/year
- Predominant age: 0–4, 15–19, and >65 years
- Predominant gender: Male > Female
Risk Factors
Alcohol, prior head injury, contact sports
Geriatric Considerations
Subdural hematomas are common after a fall or blow in elderly; symptoms may be subtle.
General Prevention
- Safety education
- Seat belts; bicycle and motorcycle helmets
- Protective headgear for contact sports
Pathophysiology
Initial brain dysfunction from direct trauma (bleeding, laceration) followed by secondary injury due to cerebral edema, continued bleeding, decreased blood flow
Etiology
- Motor vehicle accidents (17%)
- Falls (35%)
- Assault
Pediatric Considerations
Child abuse: Consider if dropped or fell <4 feet (e.g., off bed, couch) and significant injury present or any retinal hemorrhages
Commonly Associated Conditions
Alcohol and drug abuse
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