Group - 3

CHAIRMAN: RABEL RELIANTA ZAGOTO

SECRETARY: EKAL SURANTA
MEMBERS:
ALVI SHIFA
AMELISA LATERSIA P.
ARIJAL AZMI
CHRISTIAN FRANATA P.
DIANA AGUSTINA R.
EKA WATI SITUMEANG
HASAN CHAMRAN
DOSEN TUTORIAL: Dr. MAYA SARI

MARIANI NAPITUPULU
RONA PUSPITA SARI
VIDYA RACHMATULLAH
VELLY ADHITA
WILLIAM HALIM
WINITA JOSIKA

Scenario
A boy, Roni 17 years riding a motorcycle crashed due to
inconsiderate. Roni not use the helmet. After the accident roni
unconscious for 30 minutes and bleeding from the nose and ears.
Roni be helped by local people to take him to the nearest hospital.
In the RS, Johnson had regained consciousness, but he could only
groan in pain, eye opening if ordered alone, and avoid painful
stimuli, Roni also projectile vomiting 3 times while in the ER.
Presens Status: sens: Somnolence, BP: 130/80 mmHg, HR: 100
times / min, RR: 24 x / minute. On examination found Raccoon
Eyes and Battle bilateral positive sign.
What happened to Roni?

Etiology head injury

According to Aaron Cholik Rosjidi and Saiful Nurhidayat
etiology of head injury are:
a. Traffic accidents
b. Fall
c. Punch / violence
d. Falling objects
e. Occupational accident or industrial
f. Birth injury
g. Gunshot wounds

Classification of head injury

1.
2.
3.
4.
5.
6.
7.

Head injuries can be classified in various aspects.

Practically known 3 classification descriptions are based on:
The mechanism of injury
Weighing injury
Morphology
Diffuse brain injury
Epidural Hemorrhage
Subdural hemorrhage
Contusions and intracerebral hemorrhage

CLINICAL SYMPTOMS head injury

a.

Battle sign (blue or ekhimosis behind the ear over the mastoid os)

b.
c.

Hemotipanum (bleeding in the area of the tympanic membrane of the ear)

Raccon Eye / Periorbital ecchymosis (black color eye without direct
trauma)

d.
e.

Rhinorrhoe (serobrospinal fluid out of the nose)

Otorrhoe (serobrospinal fluid out of the ear)

ANAMNESI SYMPTOMS head injury

S
More detailed history about:
a. The nature of the accident
b. When it happened, a few hours / days before being
taken to the hospital
c. Whether there is a clash of heads straight
d. State of the patient during the accident and the
change of consciousness until examined.

Examination head injury

Examination of head trauma by Greaves and Johnson, among
others:
1. Status of vital functions
2. Examination of consciousness
3. Pupil Examination
4. Neurological Examination
5. Examination of the scalp and skull

Investigations head injury

1. CT Scan
Used to detect fractures of the base of the skull
or skull cavity
2. X - ray skull
X - ray skull can be used for blunt head injury and
sharp
3. Magnetic Resonance Imaging (MRI)
MRI is able to show lesions in the substantia alba
and brain stem are often missed on CT - Scan.
4. Cerebral Angiography Ct (CT - A)
This examination may indicate the presence of
vascular injury at the base of the skull which
causes patients at risk of stroke.

MANAGEMENT head injury

Early treatment head injury
1. PRIMARY SURVEY
- Airway
- Breathing
- Circulation

2. Hyperventilation
3. Intravenous Fluids

HOW TO REFER PATIENTS head injury

1. The referring physician
2. Information for the person who will accompany
3. Documentation
4. Treatment before referring
5. Management during transport
6. Transfer data

COMPLICATIONS OF HEAD
INJURY
Complications are common and
dangerous in head injury, namely:
1. Fracture of skull
2. Bleeding intrakarnial
3. Convulsions
4. Infection
5. Alzheimer's disease and Parkinson's
6. Coma

PROGNOSIS HEAD INJURY

Prognosis is related to the degree of
consciousness on arrival at hospital
GCS Now Arriving

Mortality

15
8 12
<8

1%
5%
40%

conclusion
Roni 17 years falls due to riding a
motorcycle, after the accident roni
experiencing rhinorrhoe and otorrhoe and
vomiting proyekti 3 times while in the ER.
On examination found positive Raccon
bilateral eyes, the battle to sign and
value of GCS = 9 (medium). Roni
experienced a head injury. Actions taken
are the primary measures of survey then
refer or consult a surgeon.