Management of Traumatic Intracranial Hemorrhage in the Emergency Department (Trauma CME) | Pearls
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Management of Traumatic Intracranial Hemorrhage in the Emergency Department (Trauma CME)

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Points & Pearls Excerpt

  • Approximately half of patient with Glasgow Coma Scale (GCS) score of ≤14 after traumatic brain injury (TBI) are found to have traumatic intracranial hemorrhage (ICH).2
  • Pressure within the skull is generated by blood, brain, and cerebrospinal fluid. Figure 1 illustrates the basic principles of these pressures.
  • Moderating intracranial pressure (ICP) in TBI with a goal of <22 mm Hg is to decrease the chance for herniation and to maintain cerebral perfusion pressure (CPP) >60 mm Hg. CPP <50 mm Hg will cause ischemia and <30 mm Hg is incompatible with life.
  • Due to age-related cerebral atrophy, older patients may be less symptomatic from elevated ICP; however, as veins may become adherent to the skull in older patients, small-volume, cumulative subural hematoma may result from relatively minor trauma.
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Publication Information
Authors

Erin D’Agostino, MD; Miguel Reyes-Zaragoza, MD, MS; Matthew Siket, MD, MHCI, FACEP; Ashley Weisman, MD (In Rural Life* )

Peer Reviewed By

Marc Kanter, MD, FACEP; Eric Legome, MD; Erin D'Agostino, MD (In Rural Life*)

Publication Date

February 1, 2025

CME Expiration Date

February 1, 2028    CME Information

CME Credits

4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAFP Prescribed Credits, 4 AOA Category 2-B Credits.
Specialty CME Credits:Included as part of the 4 credits, this CME activity is eligible for 4 Trauma CME credits, subject to your state and institutional approval.

Pub Med ID: 39836567

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