Cognition and generalized rigidity


on amount of bleeding. When bleeding begins, the blood will begin to compress the brain and

cause the intracranial pressure (ICP) to increase. As the ICP increases, the bleeding veins are

compressed eventually slowing the bleeding. Symptoms include headache, drowsiness,

confusion, slowed cognition and generalized rigidity (McCance & Huether, 2014).

Most Emergent Patient

The patient requiring immediate emergency surgical intervention would be the 25 year

old. This is in part due to the fact of extradural hematomas primarily come from the artery

causing rapid bleeding. McCance and Huether (2014) report the prognosis to be good prior to

bilateral dilated pupils noted. The authors also note these hematomas to be medical emergencies

almost always. This is not to say the 65 year old patient doesn’t need an intervention. They most

likely will due to becoming symptomatic. However with the subdural hematoma most likely

being venous it is a slower bleed than arterial. Additionally, with the fall occurring earlier in the

week and more recently developing increased confusion, he has the potential of remaining more

stable than the 25 year old patient.

Patient Scenario 2

A 38 year old was driving his 1970 Chevy Corvette to a Milwaukee Brewers baseball game when

a deer jumped out in front of him on the highway. He swerved his car and hit a telephone pole

instead. His head hit the windshield and he suffered severe head trauma.

Type of Head Injury

The patient ultimately suffered a focal traumatic brain injury, more specifically a coup

and contrecoup brain injury. Upon hitting his head, it threw his head forward hitting the

windshield (coup). This was then followed by his head going backward (contrecoup). “The focal

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