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Why is the brain an important organ? What is it responsible for?
vital functions
learning and memory
reproductive activities
emotions and motivations
circadian rhythms and sleep
How many neurons are in the brain? How many synapses?
86 billion neurons and each neuron is made up of 200,000 synapses
How many glial cells are in the brain?
85 billion
Why is the brain a demanding organ?
contributes to 2% of body weight
needs 15-20% of blood supply
needs 20% of daily energy
What is a traumatic brain injury (TBI)?
induced structural damage and/or physiological disruptions of brain function as a result of a physical external force
True or False: In a TBI, the insult is not of degenerative or congenital nature.
true
How can TBIs happen?
closed brain injury
penetrating brain injury
What is a closed brain injury?
there is not a break in the skull
What is a penetrating brain injury?
there is a break in the skull
What are some physical symptoms of a TBI?
loss of consciousness
headache
nausea
sleeping disorders
blurred vision
What are some mental symptoms of a TBI?
memory problems
speaking disorders
depression
How many deaths per year do TBIs cause?
more than 60,000
How many hospitalizations per year do TBIs cause?
more than 370,000
How many emergency department visits do TBI's cause?
more than 2,000,000
True or False: TBI is the leading cause of death in young and healthy people.
true
What are the three classifications of TBI?
mild (concussion)
moderate
severe
What are the characteristics of a mild TBI (concussion)?
normal brain imaging
0-30 minutes of loss of consciousness
less than 24 hours of an altered mental state
less than 1 day of post-trauma amnesia
13-15 score on the Glasgow Coma Scale
What are the characteristics of a moderate TBI?
normal or abnormal brain imaging
30 minutes-24 hours of loss of consciousness
more than 24 hours of an altered mental state
1-7 days of post-trauma amnesia
9-12 score on the Glasgow Coma Scale
What are the characteristics of a severe TBI?
normal or abnormal brain imaging
more than 24 hours of loss of consciousness
more than 24 hours of an altered mental state
more than 7 days of post-trauma amnesia
a score of 9 or less on the Glasgow Coma Scale
What is the Glasgow Coma Scale?
a measurement of a patientās level of consciousness
What 3 measurements does the GCS contain?
eye opening response
verbal response
motor response
What is the minimum GCS score?
3
What is the maximum GCS score?
15
What is a coma?
a deep and prolonged state of unconsciousness
What is persistent vegetative state (PVS)?
a state of altered consciousness where the patient appears to be awake but does not have a meaningful response
What percentage of individuals who suffered a severe TBI can develop some independent living capabilities?
15%
What percentage of individuals who suffered a mild TBI have symptoms one year later?
10-15%
What is a mild TBI/concussion?
a temporary loss of neurological function without apparent structural damage
For a concussion to occur, what does the patient not need to be/have?
unconscious
directly hit to their head
have amnesia
What is post-concussion syndrome (PCS)?
the constellation of symptoms that persist after mild TBI
What can the symptoms of PCS be?
physical
cognitive
behavioral
emotional
What are some common symptoms of PCS?
headache
dizziness
anxiety
insomnia
problems with concentration and memory
True or False: Patients who suffer more than one TBI are at an increased risk for PCS.
true
What are the three biomechanical forces resulting in a TBI?
linear (translational) acceleration
rotational (angular) acceleration
impact deceleration
What is a coup injury?
the damage occurs directly under the site of impact
What is a counter-coup injury?
the damage occurs on the side opposite from the impact
What is a primary injury?
results from mechanical injury at the time of trauma
What are two primary injuries?
diffuse axonal injury (DAI)
hematomas/hemorrhages
What is a secondary injury?
caused by the physiological responses to the initial injury and include a series of neuro-electro-chemical cascade events
What are three secondary injuries?
excitotoxicity
ischemia
inflammation
What is a cerebral hemorrhage?
uncontrolled bleeding inside the brain
What is a cerebral hematoma?
a blood clot in the brain
What is a cerebral contusion?
a bruise of the brainās surface that extends down through the cortex
True or False: The pressure-volume relationship within the cranium approximates an exponential curve.
true
What is cerebral ischemia?
a condition in which there isnāt enough blood flow to the brain to meet metabolic demand
What is cerebral hypoxia?
a condition in which there is a decrease of oxygen supply to the brain
What is brain herniation?
a pressure gradient originating from the lesion site that causes displacement of brain tissue
What is a diffuse axonal injury (DAI)
the shearing/tearing of axons that lead to disconnection or malfunction of neuronsā interconnections
What does DAI induce in regards to the AB peptide?
extensive axonal pathology with retraction bulb and varicosities
Where does amyloid precursor proteins (APP) accumulate?
injured neurons
What does sequential APP proteolysis generate?
the neurotoxic amyloid B (AB) peptide
What is the crucial step in the development of Alzheimerās disease?
APP proteolysis generates the AB peptide
What does DAI induce in regards to the tau protein?
accumulation and spread of phosphorylated tau protein
What is sprouting?
restoration of damaged neural circuits by growing new dendrites, axons, and synapses
What does the generation of new neurons depend on?
neuronal replacement depends on the maintenance of a neural stem cell
What is functional compensation?
uninjured areas of the brain take over the functions lost or reroute information around the injured area
What does the success of brain injury rehabilitation depend on?
nature and severity of the brain injury
type and degree of any resulting impairments and disabilities
overall health of the patients
family support
Note 
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