Head Trauma

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Head Trauma
basic craniotomy instrument set

Head trauma

Head trauma affects hundreds of thousands of people every year.

The calculated annual incidence is 281 people affected per 100,000 populations, with predominance twice as high for males. As an indication and according to data that are already a little old, road accidents represent the leading cause of head trauma in France (60% of hospitalizations for head trauma, and 70% of deaths from head trauma), with a peak of frequency between 15 and 30 years.

The second cause identified is falls (30% of hospitalizations and 14% of deaths), with two frequency peaks, one before 5 years and the other after 70 years. Gun wounds only represent less than 1% of admissions but account for 13% of deaths. Among the risk factors for accidents, we must remember the importance of acute alcoholism as a factor contributing to falls as well as traffic accidents.

The severity of a head trauma depends on the brain lesions caused by the dissipation of the physical energy involved. These are lesions of the brain created by the physical phenomena of acceleration-deceleration which bring forces into play. The consequences on neuronal functioning are immediate; they are transitory in the event of astonishment of the function, or definitive in the event of anatomical lesion. More rarely, it is a penetrating wound that creates permanent direct cortical brain damage. Small wounds can be cure with basic craniotomy instrument set.

The brain is the main intracranial organ affected because of its weight, its volume in the cranial case, and its internal and external configuration. The cerebellum and brainstem are more often spared. But the whole brain is subject to the same risks of ischemic or hypoxic lesions secondary to the circulatory and respiratory disorders suffered by the injured person. The same is true for a whole register of cell damage resulting from a cascade of biochemical events triggered by hypoxia or the presence of blood in the brain.

The first major and immediate consequence of a head injury is loss of consciousness. It is a sure sign of concussion, that is, of a shaking of the brain structures with suspension of their function. It can be brief or prolonged. That’s why we’ll talk about either a brief loss of consciousness or an immediate coma. It measures the severity of a head trauma by its duration and also by its depth assessed by the neurological examination of the injured.

The faster the injured person wakes up, the greater their chances of a return to normal. Among all head trauma victims, it is estimated that 90% of them will have no consequences, 5 to 8% will have major sequelae, and 1% will have severe sequelae (pauci-relational state or persistent vegetative state) . Post-traumatic epilepsy is a sequel for 3% of all trauma victims, mostly severe head trauma victims. It must be remembered, however, that even the full and rapid recovery of the injured is not sufficient evidence to say that there was no brain damage or to say that there will be no after-effects.


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