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ICD-9-CM Codes (Abbreviated)

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  • See end of entry for full list

  • 803 Other and unqualified skull fractures

    • 803.0 Other closed skull fracture without mention of intracranial injury

    • 803.1 Other closed skull fracture with cerebral laceration and contusion

    • 803.2 Other closed skull fracture with subarachnoid subdural and extradural hemorrhage

    • 803.3 Closed skull fracture with other and unspecified intracranial hemorrhage

    • 803.4 Closed skull fracture with intracranial injury of other and unspecified nature

    • 803.5 Other open skull fracture without mention of intracranial injury

    • 803.6 Other open skull fracture with cerebral laceration and contusion

    • 803.7 Other open skull fracture with subarachnoid subdural and extradural hemorrhage

    • 803.8 Other open skull fracture with other and unspecified intracranial hemorrhage

    • 803.9 Other open skull fracture with intracranial injury of other and unspecified nature

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Preferred Practice Pattern1

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Key Features

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Description

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  • Defined as external trauma to the skull that results in damage to one or more parts of the brain

  • Fracture of the skull

    • Open head injury (penetrating): fracture of the skull with brain injury

    • Closed head injury (blunt, non-penetrating): skull remains intact, but brain injury is evident.

  • Depressed skull fracture: break in a cranial bone with depression toward the brain

  • Linear skull fracture: break in a cranial bone, thin line without splintering, depression, or distortion of the bone

  • Initial presentation will range from comatose to ambulatory and verbal depending on the extent and location of damage

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Essentials of Diagnosis

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  • Damage to the brain may result in changes or dysfunction to any body functions including:

    • Motor loss

    • Sensory loss

    • Autonomic dysfunction

    • Perceptual changes

    • Cognitive, personality, and behavioral changes

    • Changes in consciousness

    • Communication difficulties

    • Eating, swallowing, bowel, and bladder changes

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General Considerations

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  • Delayed effects of the trauma are common.

  • Full extent of the injury is not known at the time of injury.

  • Intracranial swelling must be addressed/controlled before the full extent of the damage can be identified.

  • Swelling will cause secondary damage to parts of the brain that were not impacted by the initial trauma.

  • Cerebral hypoxia and/or ischemia, cerebral hemorrhages, electrolyte imbalances, infections from open wounds/open head injury, and seizures are common.

  • Physical activity is contraindicated until the full effects of the brain injury are known and the patient has stable intracranial pressures.

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Demographics2

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  • American Trauma Society estimates approximately 500,000 people are admitted to the hospital each year in America due to cerebral trauma; 75-90,000 die from the cerebral trauma, and many others remain permanently disabled.

  • Most commonly injured are between the ages of 15 ...

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