head injury

1. Case Presentation
Presented by:
Sagar Kishor Savale
B-pharm final year
Exame No- 528510
Department of Clinical Pharmacy
R. C. Patel Institute of Pharmaceutical Education &
Research; Shirpur.
Dist: Dhule, Maharashtra.
Date:27/04/2015.

3. Name Mr. xyz
Address Shirpur
Age 38 yrs
Sex Male
Weight 59 kg
Hospital name Shri Siddheshwar Multispeciality
Hospital Deopur , Dhule 424002
DOA 10/04/2014
DOD 18/04/2014
Consultant Doctor Dr. Thakar Sir And Desale sir
PATIENT PROFILE:

4. Occupation Shopkeeper
Social History Vegetarian
Family History Nil
Diagnosis:
Final diagnosis Head injury
Associated Disease Right Clavicle Damage

6. LAB DATA REPORTS
On 10th April,2014
Hb - 14 mg/dl (13.8-17.2mg/dl)
WBC - 14500 million/mm3
Creatinine - 1.3mg/dl (0.7 to 1.2 mg/dl
Urea / sugar - 102 mmol of glucose per litre
of plasma

7. EXAMINATION FINDINGS
CNS EXAMINATION
B.P :- 130/80 mmHg
CVS EXAMINATION
Pulse rate :- 98/min
Respiratory System Examination:
Respiaratory rate :- 18/min

8. Diagnosis Parameters-
1. CT scan
2. MRIscan (Magnetic resonance imaging )
3. Skull x-rays
4. Arteriography
DIAGNOSIS :-
Patients was diagnosed with head injury and right clavicle
damaged.
 Computed tomography (CT) has become the diagnostic
modality of choice for head trauma due to its accuracy,
reliability, safety, and wide availability.

9. Head injury
Any injury that results in trauma to the skull, or brain is known as head
injury.
Any trauma to the scalp, skull, or brain i.e. head injury
classification includes neuronal injuries, hemorrhages, vascular
injuries, cranial nerve injuries, and subdural hygromas, among many
others.
there are many causes—including accidents, falls, physical
assault, or traffic accidents ,Motor vehicle accidents , Sports-related
injuries —that can cause head injuries.

10. Symptoms of mild head injury :
• a mild headache
• nausea (feeling sick)
• mild dizziness
• bleeding in the brain
Signs of a severe head injury can include:
• unconsciousness – either brief (concussion) or for a
longe period of time
• fits or seizures – when the body suddenly moves
uncontrollably
• difficulty speaking or staying awake
• problems with the senses – such as loss of hearing or
double vision
• repeated vomiting
• blood or clear fluid coming from the ears or nose
• memory loss (amnesia)

11. Treatment
MEDICATION DETAILS

12. Sr.no medication dose Std.dose Frequency
1 Inj.cefabact (Ceftriaxone) 1 gm 1 gm b.i.d.
2 Inj.rantac (ranitidine) 50 mg/ml 50 mg/ml b.i.d
3 Inj.zofer (odensteron) 4 mg/ml 4 mg/ml b.i.d
4 Inj.zemisole 100ml 100ml b.i.d
5 Inj.fasolin(fosphenytoin) 750mg 750 mg b.i.d
6 Inj.dynapar (dyclofenac sodium) 25 mg/ml 25 mg/ml b.i.d
7 Tab.cefedinir 300mg 300mg b.i.d
8 Tab.rantac D 150 mg 150mg-300mg b.i.d
9 Tab.emanzen D(diclofenac) 50mg/10mg 50mg/10mg b.i.d
10 Tab.epsolin(phenytoin) 100 mg 100 mg b.i.d
11 syp.glycerol 15 ml 15 ml b.i.d
route
I.V.
I.V.
I.V.
I.V.
I.V.
I.V.
Oral
Oral
Oral
Oral
Oral

13. DISCUSSION
Drug Interaction:
Phenytoin has a narrow therapeutic range:
10-20 mg/L
Ranitidine increases the bioavailability of calcium channel
blockers by lowering gastric acidity.
Ranitidine when combined with furosemide, increases it’s
bioavailability.

14. PATIENT COUNSELING
1) To control bleeding, apply clean
dressings directly to scalp or facial
cuts.
2) To control swelling, apply ice for 20 to
30 minutes every 2 to 4 hours.
3) For headache, give over-the-counter
acetaminophen. Do not use
aspirin,ibuprofen, or other anti-
inflammatory drugs, which can increase
the risk of bleeding.
Call 911 if the person has any of the
following
symptoms:
1. Blood or clear fluids coming from the
ears or nose
2. Unconsciousness, confusion,
dizziness, or drowsiness
3.Unequal pupil size or blurred or double
vision

15. Preventing head injuries
Always use safety equipment during activities
that could cause a head injury. These include seat
belts, bicycle or motorcycle helmets, and hard
hats.
Learn and follow bicycle safety
recommendations.
Do not drink and drive

16. REFERENCES
en.m.Wikipedia.org/wiki/head injury
www.autismtreatmentindia.com
Emedicine.Medscape.com
www.healthline.com/health/head -injury
www.mayoclinic.org/.../traumatic-brain-...
www.drugdiggest.com
www.wikipedia.com
www.netdoctor.com

17. Thank you for listening me………