ANOXIC BRAIN INJURY
Anoxic brain injury is injury to the brain from lack of oxygen (from cardiac arrest,
choking, or drowning). Spasms develop in small arteries if the brain goes without
oxygen for more than 4 to 6 minutes. Blood flow does not reach the cerebral cortex.
The level of brain damage is based on the length of anoxia (lack of oxygen).
SPECIFIC TYPES OF HEAD INJURY
a. Scalp Wounds. The scalp has many blood vessels, a number of which are
close to the surface. A scalp laceration, therefore, may bleed profusely even though a
major blood vessel has not been cut. Initially, even a minor laceration may bleed a
great deal. Normally, blood in the scalp clots rapidly, and blood flow can be controlled
easily. If necessary, bleeding can usually be controlled by direct pressure; that is, by
compressing the scalp between the fingertips and the skull. It is important to control
bleeding in both adults and children, but it is especially important in children because
they have a smaller volume of blood.
b. Skull Injuries. The skull is composed of the cranium and the face. Skull
fractures are commonly fractures to the cranium rather than the face.
(1) Signs/symptoms of skull injuries. The most obvious signs of a skull
fracture are visible bone fragments and bits of brain tissue. The possibility of a skull
fracture exists when any of the following less obvious signs/symptoms are present:
(a) Following an injury, the patient may be either unconscious or have
an altered level of consciousness.
(b) The patient has sustained an injury that has caused a deep
laceration or severe bruises to the scalp or forehead.
There is severe pain or swelling at the site of a patient's head
(d) There is a deformity of the patient's skull; for example, a depression
in the cranium, a large swelling, or anything that looks unusual about the cranium's
(e) The patient has a bruise or swelling behind the ear (Battle's sign -
discoloration behind the ear caused by a fracture in the base of the skull). This sign
may appear hours to days after the injury.
The pupils of the patient's eyes are unequal in size.