[Verse 1] Roadside to recovery, learn the sequence cold — Primary injury's done the moment contact's told, Coup and contrecoup, the brain rebounds and shears, Rotational forces tearing axons across the years. Diffuse axonal injury, grade it one to three, Petechiae in the corpus, deep white matter bleeds. Contact loading fractures bone, inertia rips the tracts — Biomechanics carved in physics, not in abstract facts. [Chorus] Six secondary insults — memorise the chain: Hypotension, hypoxia, hypercapnia's bane, Hyperthermia, glycaemia swinging either way, Seizure and anaemia stealing outcome every day. Stop the second hit before the neuron drowns — Coagulopathy reversed before the pressure mounds: PCC for warfarin, idarucizumab for dabigatran's grip, Andexanet for the factor-ten inhibitor drip. [Verse 2] Scalp bleeds wide, the calvaria rings and cracks — Basilar fractures telegraph their trail through subtle facts: Battle's sign bruising retroauricular and late, Raccoon eyes collecting blood around the orbital plate, Haemotympanum, CSF trickling from the ear, Beta-two transferrin confirms what you suspect and fear. Growing skull fracture in the paediatric case — Leptomeningeal cyst pulsing through the bony space. [Verse 3] Epidural — arterial, the middle meningeal tears, Lucid interval then coning if the surgeon disappears. Thirty-mil volume, five-mil thickness, fifteen-shift — the gate For operative drainage; posterior fossa won't wait. Acute subdural bridging veins avulsed and burst — Malignant swelling, cortex infarcted at its worst. Timing matters: every hour erodes the ground, Thickness over ten or shift beyond five millimetres found. [Bridge] Chronic subdural — membranes weave angiogenic nets, Recurrent microhaemorrhage feeding slow regrets. Burr hole with a drain — the evidence tips the scale, Dexamethasone trials hedging, MMA embolisation on the trail. Penetrating wounds — trajectory decides the fate, Debride the devitalised, leave deep fragments, watch and wait. Denver criteria screening for the blunt vascular blow — Dissection, pseudoaneurysm, carotid-cavernous flow. [Chorus] Six secondary insults — memorise the chain: Hypotension, hypoxia, hypercapnia's bane, Hyperthermia, glycaemia swinging either way, Seizure and anaemia stealing outcome every day. Stop the second hit before the neuron drowns — Coagulopathy reversed before the pressure mounds: PCC for warfarin, idarucizumab for dabigatran's grip, Andexanet for the factor-ten inhibitor drip. [Outro] CSF rhinorrhoea — watch the meningitis clock, Prophylactic antibiotics: evidence says don't unlock. Seven days to spontaneous seal, repair if it persists — Endoscopic or craniotomy, the neurosurgeon insists. From the kerbside to the theatre, rehabilitate the mind — Every decision layered, every deficit refined. Primary's done, but secondary bends to what we know — Manage every insult, let the salvaged neurons grow.
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