Trauma Capitis

Primary Traumatic Head Injury

Secondary Traumatic Head Injury
Primary Traumatic Head Injury
 Fraktur
 Lacerasi scalp ( perdarahan pada kulit )
 EDH ( Epidural hematome, antara tulang kepala dan dura )
 SDH ( Subdural hematome, antara dura dan arachnoid )
 SAH ( Subarachnoid hemorrhage )
 Cerebral contussion ( a bruis of the brain, perdarahan otak )
 Concussion ( gegar otak; a loss of function due to trauma )
 Punch-drunk syndrome ( oleh repetitive head injury, boxing )
 Coma---->death
 Shaken Baby Syndrome ( child abuse )
Secondary Traumatic Brain Injury
 Terjadi beberapa jam sampai beberapa hari setelah primary
brain injury.
 Mempunyai peran yang besar pada kerusakkan otak dan
kematian penderia.
 Ischemi, Hypoxy, Hypotensi, cerebral edema,perubahan
aliran darah, tekanan intracranial meningkat, herniasi otak,
brain death, acidosis, meningitis, abses otak, kerusakkan BBB,
perubahan pelepasan neurotransmitter, masuknya ion-2 Ca
dan Na kedalam neuron, disfungsi mitochondria, kerusakkan
sel-2 otak oleh adanya radical bebas, free radical overload.
Trauma Capitis
Closed Head Injury, tulang kepala
masih intact.

Open Head Injury, tulang kepala

patah.
 GCS PTA LOC

Mild 13-15 < 1day 0-30 minutes

Moderate 9-12 > 1day to < 7 > 30minutes

days to < 24 hours

Severe 3-8 > 7days > 24 hours

PTA = Post Traumatic Amnesia

LOC = Loss Of Consciousness
Imaging Technique in TBI
CT scan
MRI scan
CT scan
 CT scanning is the first imaging technique
to be used.
 CT demonstrate the scalp, bone, extra-
axial hematomas,and parenchymal injury.
 CT is rapid and easily done in the presence
of multiple monitors that many trauma
patients have in place.
 CT is very sensitive for detection of
intracranial head injury.
 Kesulitan CT scan adalah mendeteksi:
Extracerebral-intracranial hemorrhage:
 Regio infratemporal.
 Subfrontal.
 Perdarahan fossa posterior.

Kurang sensitif:
 DAI
 Vascular injury
CHRONIC EPIDURAL HAEMATOME
Interhemispheric SDH
Coup Countercoup
Multiple Head Injury
Pneumoencephaly
DAI : Diffuse Axonal Injury:
Bintik-2 perdarahan pada : Batas Grey danWhite matter; Capsula interna; Corpus
callosum; Upper brain stem.
Gradient Echo ??
Gradient Echo ??
FLAIR
DWI
MR T1W
 Shaken Baby Syndrome
Tulang-2:
 Patah tulang calvaria: Diastasis, Comminutiva, Linear.
 Fraktura kompressi vertebra, Fraktur-dislokasi, kompressi
discus, fraktur processus spinosus.
 Hematome cervical cord.
Brain Injury:
Contusio cerebri, Difus edema cerebri, SDH, SAH, EDH, IVH.

Orbita: Perdarahan retina