Neuro Case Study Comprehensive Nursing Paper Sample

Neuro Case Study Comprehensive Nursing Paper Sample

Patient 1

Traumatic brain injury causes extradural hematuria (EDH) and subdural hematuria (SDH). EDH (spinal EDH if bleeding occurs within the spine) constitutes a blood clot forming outside the dura mater (Aromatario et al., 2021). The bleeding occurs between the dura mater and the skull, contributing to approximately 2% of all head injuries presented in emergency departments. This type of head injury has increased morbidity and mortality potential, primarily in men of advancing age. Aromatario et al. (2021) illustrate that EDH injuries are caused by motor vehicle accidents, falls, and sporting activities among those presenting with parietal-temporal fractures. Additionally, EDH bleeding usually originates from the middle meningeal artery due to pterion fracture, causing symptoms like headache, seizures, coma, breathing problems, loss of brain function, and death (Prabhu et al., 2019). During EDH, injuries cause the tearing of brain arteries or veins, causing blood leakage into the dura mater and pressure buildup in the brain, resulting in significant brain injuries.(Neuro Case Study Comprehensive Nursing Paper Sample)

On the other hand, SDH is blood clotting forming inside the dura matter and is associated with approximately 25% of head injuries (Aromatario et al., 2021). Blood accumulation in the dura mater increases blood pressure in the brain, causing challenges in breathing, paralysis, and death. It is most prevalent in older people and results in headaches, seizures, memory loss, and coma (Pierre & Kondamudi, 2023). Falls, sporting activities, and accidents are the most common causes of SDH, with patients presenting subacute, acute, and chronic trauma cases. Acute SDH causes patients to exhibit symptoms within minutes or hours, increasing the risk of paralysis or death if immediate medical attention is unavailable. In contrast, chronic SDH manifests symptoms slowly within weeks or months, especially in adults who may not remember hitting their heads (Pierre & Kondamudi, 2023).(Neuro Case Study Comprehensive Nursing Paper Sample)

Among the patients in the case scenario, the 25-year-old requires immediate emergency surgery to prevent the potential accumulation of blood in the brain. Motor vehicle accidents cause most EDH injuries, and the victim should be prioritized for emergency surgery. Any delay in emergency surgery increases the risk of brain injury or death as the blood accumulates outside the dura mater (Aromatario et al., 2021). On the other hand, the 65-year-old presents symptoms of chronic SDH-like confusion, indicating the presence of a blood clot in the brain. The patient requires emergency surgery to remove the clot, but it has some duration before the exacerbates, hence should not be prioritized.(Neuro Case Study Comprehensive Nursing Paper Sample)

Patient 2

The patient experienced coup-contrecoup brain injury and has an increased risk of developing subdural hematuria. The injuries affect two sides of the brain, the actual area of impact and the opposite point of impact. Payne et al. (2023) observe that coup injuries occur directly at the impact site, while contrecoup injuries occur from contusions on the opposite site. On the other hand, contrecoup injuries are attributed to forces manifesting within the intracranial cavity produced by brain stress when it forcefully moves within its cavity (Payne et al., 2023). These injuries are mainly caused by falls and motor vehicle accidents, resulting in headaches, memory loss, coma, and dizziness.(Neuro Case Study Comprehensive Nursing Paper Sample)

Payne et al. (2023) illustrate that patients with coup-contrecoup brain injuries are treated based on injury severity. For instance, Computerized Tomography (CT) scan (within 12-24 hours) should be conducted on lesions not requiring immediate decompression. Besides, patients with reduced neurological status based on the Glasgow coma scale eight should receive intracranial pressure monitoring. However, patients with extensive injuries should receive emergency surgery and can be subjected to hematuria drainage and lobectomy (Payne et al., 2023). The patient should also be given antiepileptic medications like phenytoin and levetiracetam within seven days to treat symptoms associated with trauma. Moreover, Fotros and Bajestan (2022) explain that the patient should be subjected to therapeutic rehabilitation, such as physical, occupational, speech, and cognitive training to improve coup-contrecoup injury outcomes. Rehabilitation enables patients to transition effectively into performing activities throughout recovery.(Neuro Case Study Comprehensive Nursing Paper Sample)

References

Aromatario, M., Torsello, A., D’Errico, S., Bertozzi, G., Sessa, F., Cipolloni, L., & Baldari, B. (2021). Traumatic epidural and subdural hematoma: epidemiology, outcome, and dating. Medicina, 57(2), 125(Neuro Case Study Comprehensive Nursing Paper Sample). https://doi.org/10.3390%2Fmedicina57020125

Fotros, A., & Bajestan, S. N. (2022). HEAD INJURY AND ITS SEQUELAE. Concise Guide to Neuropsychiatry and Behavioral Neurology, 265. ISBN: 9781615374090(Neuro Case Study Comprehensive Nursing Paper Sample)

Payne, W.N., De Jesus, O., & Payne, A.N. (2023). Contrecoup Brain Injury. In: StatPearls. Treasure Island (FL): StatPearls Publishing,(Neuro Case Study Comprehensive Nursing Paper Sample) https://www.ncbi.nlm.nih.gov/books/NBK536965/

Pierre, L., & Kondamudi, N.P. (2023). Subdural Hematoma. In: StatPearls. Treasure Island (FL): StatPearls Publishing, https://www.ncbi.nlm.nih.gov/books/NBK532970/ Prabhu, S., Agarwal, S., & Prabhu, S. (2019). Spontaneous intracranial extradural hematoma secondary to hypofibrinogenemia: A rare case report. Asian Journal of Neurosurgery, 14(04), 1288–1290. DOI: 10.4103/and.AJNS_143_1(Neuro Case Study Comprehensive Nursing Paper Sample)