Question: Sally Hartford, Age 25, Was Bicycle Riding With Friends When She Was Thrown From Her Bike. She Was Briefly Unconscious, Got Up, Appeared Oriented And Said She Just Saw “stars.” Paramedics Were Called. On The Scene, She Was Immediately Placed On Backboard And Cervical Collar Prior To Transport To The Emergency Room. Sally Was Admitted To The Emergency …

Sally Hartford, age 25, was bicycle riding with friends when she was thrown from her bike. She was briefly unconscious, got up, appeared oriented and said she just saw “stars.” Paramedics were called. On the scene, she was immediately placed on backboard and cervical collar prior to transport to the emergency room. Sally was admitted to the Emergency Department where a physical exam revealed she was alert and oriented, all neurological function intact, T98, PR 82/min, RR 20/min, BP 120/70. She complained of a mild headache. X-rays and CT scans show a linear fracture of R temporal bone over the middle meningeal artery area. She is admitted for observation. Two hours post admission, the nurse observes that Sally is becoming restless, level of consciousness (LOC) decreasing, changes in speech pattern, pupil dilating on R side, grips and pushes on L side weaker than R Neurosurgeon is notified and Sally is prepared for surgery. Sally returns from surgery post evacuation of R epidural hematoma and vascular repair of R middle meningeal artery. She has R bone flap, a ventriculostomy connected to the monitor. Her soft helmet dressing is clean and dry. Vital signs: T980. P 80, R 18, BP 120/60. Questions: 1. Compare and contrast the different types of head injuries: (2 points) diffuse axonal injury epidural hematoma subdural hematoma intracerebral bleed subarachnoid bleed concussion /contusion 2. Based on Sally’s condition, what are the clinical manifestations indicating that she is experiencing increasing intracranial pressure? (1 point) 3. Discuss the pathological mechanisms involved in increasing intracranial pressure (ICP). 2 points Discuss at least 3 methods of medical management for increasing intracranial pressure. (2 points)