Cranial Trauma
0 While the first preferred diagnostic method in orbital fractures is direct radiography taken in the Caldwell position, the best diagnostic method is CT.
0 Cerebral concussion; It is the condition that defines the group of findings such as cognitive impairment, headache, memory disorders, syncope secondary to head traumas (usually minor). It can be differentiated from contusion by the absence of obvious imaging findings.
0 Cerebral contusion; It is a picture in which petechial hemorrhages are usually seen as a result of physical distortion of the brain tissue. Bleeding and edema may also accompany the picture.
Cephal Hematoma
Subperiosteal hematoma
• It is the accumulation of blood between the cranium and the periosteum.
• It can be seen unilaterally or bilaterally and usually occurs in the parietal region.
• Does not exceed suture lines.
Subgaleal hematoma
• It is the accumulation of blood between the galea aponeurotica and the periosteum.
• It tends to spread past the suture lines.
• 250 cc of blood may accumulate. This amount can cause hypovolemia in the infant.
• Local cold application is made. It usually resolves within 2-3 weeks.
Epidural Hematoma
Epidural bleeding and accompanying fracture
0 It is the accumulation of blood between the cranium and dura.
0 90% of cases have fractures.
0 Bleeding usually occurs from middle meningeal artery, fractured bone margins (diploe distance).
0 They are usually seen in temporal bone fractures.
0 Epidural hematoma is the most urgent type of intracerebral hemorrhage.
0 After a short period of being conscious after trauma, loss of consciousness develops (Lusid interval).
0 Epilepsy, signs of increased intracranial pressure syndrome (vomiting, bradycardia, headache) may be seen.
0 If it is not drained quickly, intracerebral herniation develops.
0 Burr-Hole is opened, hematoma is evacuated, and the bleeding vessel is ligated.
Subdural Hematoma
Bleeding caused by rupture of the bridging veins between the dura and the arachnoid.
It can also develop at the end of cerebral contusion and intracerebral hematoma.
It can also be seen in alcoholics, drug users, and rarely in people with hypertension.
Usually there is venous bleeding.
It is most common in the temporal, parietal and frontal regions.
They are the most common lesions with mass effect after head trauma.
If the consciousness is clear, there is a very severe headache.
There may be focal neurological deficits.
Vomiting, epilepsy, subfebrile fever in children, restlessness and meningeal irritation findings may be present.
Surgical approach is required for bleeding more than 1 cm in thickness.
Acute form: It is seen in the first 24-72 hours.
Chronic form: It is seen in 3-10 days.
Chronic subdural hematoma is usually seen in infancy, the elderly, and alcoholics.
It can occur weeks or even months after a minor trauma.
A membrane develops from the dura mater. This structure is called the neomembrane (new membrane).
In these patients, forgetfulness, dementia, personality changes, fluctuations in consciousness, signs and symptoms of CRPS, hemiparesis, hemiplegia are seen with mass effect.
Mortality in acute subdural hematoma due to underlying brain injury is 50-90%.