1. scalp
2. skull
2.1. linear/ simple
2.1.1. the bone is not displaced
2.1.2. doesnot need special care
2.2. depreessed
2.2.1. if more than 5 mm need surgical elevation
2.3. base of the skull
2.3.1. anterior
2.3.1.1. Raccon eye / Rhinorrhea
2.3.2. middle fossa
2.3.2.1. battel sign / Otorrhea / hematympanum
2.3.3. posterior fossa
2.3.3.1. Rarely fructured & diagnosed by MRI
3. traumatic brain injuries
3.1. primary
3.1.1. diffuse
3.1.1.1. concussion
3.1.1.1.1. transiet loss of consciosness (5 min to 6 hrs
3.1.1.1.2. no therapeutic need just monitoring
3.1.1.2. diffuse axonal injuries
3.1.1.2.1. microscopic axonal disruption to brain
3.1.2. focal
3.1.2.1. contusion
3.1.2.1.1. bruising in the brain surface
3.1.2.2. IC Hge
3.1.2.2.1. epidural hematoma
3.1.2.2.2. subdural hematoma
3.1.2.2.3. subarachnoid Hge
3.1.2.3. intracerebral Hge
3.1.2.3.1. bleeding inside brain tissue or ventricles
3.2. secondary
3.2.1. increase ICP
3.2.1.1. lead to altered cerebral perfusion
3.2.1.2. increased by cerebral edema
3.2.1.2.1. intracranial bleeding
3.2.2. s & s of increased ICP
3.2.2.1. DLC
3.2.2.2. Projectile vomiting
3.2.2.3. cushing triad ( brady cardia / increase systolic BP / Irregular breathing )
3.2.3. maintain cerebral perfusion ( CCP = MAP - ICP )
3.2.3.1. Maintain MAP
3.2.3.2. maintain ABG
3.2.3.3. decrease metabolic demand
3.2.3.4. promote venous drainage