Musculoskeletal and Neurologic Disorders, Essay Example

A review of the findings and the manner of head injury which has been sustained by Molly, which include no loss of awareness, mild nystagmus- which may be signs of a neurological dysfunction and the dizziness and confusion which is experienced by Molly, the most probable diagnosis is labyrinthine concussion. Conventionally, the application of the terminology of labyrinthine concussion has excluded fractures of the temporal bone. The manifestations of labyrinthine concussion are dizziness, postural disequilibrium, loss of auditory range, ringing of the ears vomitus or a conjunction of these symptoms subsequent to head trauma (Akin & Murname, 2011; Alsalaheen et al., 2010; Brusis 2011; & Chiaramonte et al., 2013). Chiaramonte et al. (2013) supports the potential diagnosis as it is manifested by history, eccentric behavior, persistent headache and loss of auditory range.

The differential diagnosis should be a paroxysmal positional vertigo which was brought on by a labyrinthine concussion. Molly has the potential of completely recovering from the dizziness which she is experiencing. In reviewing the antecedents of the patient it does not demonstrate that she experienced a loss of awareness,ataxia orvomiting. As a fondoscopic examination was conducted the potential of Molly possessing a subdural hematoma is minimal. The aspect of Molly’s behavior are symptoms which are subsequent to the occurrence of a head trauma caused by the labyrinthine concussionin addition to the damage which has been caused to the supplementary peripheral and central vestibular conduits(Akin & Murname, 2011; Alsalaheen et al., 2010; Brusis 2011; & Chiaramonte et al., 2013).

The application of the labyrinthine concussion is usually exclusive of the skeletalfractures. Molly should also be checked for blood clots within her inner ear,in the event that hearing disruption should occur. In certain circumstances of labyrinthine concussion, the patient may be subject to positional vertigo. Molly may also be subject to dizziness which is brought on by Valsalva manifestations (i.e. straining,coughing andsneezing). As Molley possesses a GCS of 13, there may be a fracture of the skull or the temporal bone. The positional vertigo may be a manifestation of a longitudinal temporalbone fracture.  This differential diagnosis should be considered until a CT scancan be performed(Akin & Murname, 2011; Alsalaheen et al., 2010; Brusis 2011; & Chiaramonte et al., 2013).

Molly has a non-descript disorientation which is an aspect of the labyrinthine concussion. This non-descript disorientation is produced in half of the patients wi8th traumatic head injuries. The patient may present no laboratory or clinical irregularities. The common symptoms are disorientation, dizziness, neck pain and headaches. A CT should be performed in order to confirm the differential diagnosis. The ear drum and the hearing canal are conventionally normal subsequent to a labyrinthine concussion. In the event of a fracture of the temporal bone, there may be some   bleeding in the middle ear. It is very infrequent that thereis a rupturedeardrum or internal discharge of pus. Again this is the differential diagnosis until further tests can be performed(Akin & Murname, 2011; Alsalaheen et al., 2010; Brusis 2011; & Chiaramonte et al., 2013).

Molly’s headache symptoms may be treated with acetoiminophen and ibuprofen. These are to be administered in dosages of 10 mg of ibuprofen three times daily or 15 mg of acetaminophen four times daily. Meclizine in 25- 50 mg dosages every four hours would relieve the symptoms of Molly’s eccentric behavior. The education which should be imparted to the parent is located on the head trauma sheet. The health care provider should review all of the manifestations in order for the parents to acquire additional treatment. The health care provider should leave enough time in the examination procure to address any doubts or questions that the parents may have and to make sure that they understand the process of managing the potential labyrinthine concussion which Molly has acquired as a result of a closed head trauma(Akin & Murname, 2011; Alsalaheen et al., 2010; Brusis 2011; & Chiaramonte et al., 2013).

References

Akin, F. W. & Murname, O. D. (2011). Head injury and blast exposure: vestibular consequences. Otdaryngol Clin North Am, 44(2): 323- 334.

Alsallaheen, B. A., Mucha, A, Morris, L. O., Whitney, S. L., Furman, J. M., …, & Sparto, P. J. (2010). Vestibular rehabilitation for dizziness and balance disorders after concussion. Journal of Neurologic Physical Therapy, 34(2): 87- 93.

Brusis, T. (2011). Sensorineural hearing loss after a dull head injury or concussion trauma. Laryngorhinootologia, 2; 73- 80.

Chiaramonte, R., Bonfiglio, M., D’Amore, a., Viglianesi, A., Cavallaro, T.,& Chiaramonte, I. (2013). Traumatic labyrinthine concussion in a patient with sensorineural hearing loss. Neuroradiol J, 1: 52- 55.