TBI (traumatic brain injury)

Which age groups are most at risk for traumatic brain injury?

1–2 years, 15–24 years, and 75+ years (elderly).

What are the primary causes of TBI?

Falls, motor vehicle accidents, assaults, sports injuries

What are the classifications of TBI

Open, closed, blast, primary, secondary.

What structures protect the brain and can contribute to TBI issues?

Skull, meninges, CSF, blood-brain barrier.

What causes an open TBI?

Contact with an object like bullets or knives; skull penetration.

What causes a closed TBI?

Rapid acceleration/deceleration; no skull penetration.

What is a brain contusion?

Bruising on the brain’s surface at the time of injury.

What is a coup injury vs. countertop injury?

Coup-Brain damage at the site of impact. Countertop- Damage opposite the impact site due to brain rebounding

Name causes of acquired brain injuries.

CVA, airway obstruction, near drowning, toxins, MI

Define hypoxia.

Low oxygen in brain tissue

Define anoxia

Complete lack of oxygen

Define ischemia.

Insufficient blood flow to brain.

How does an epidural hematoma present?

Arterial bleed; brief unconsciousness → lucidity → deterioration

How does a subdural hematoma present?

Venous bleed; slower onset; common in elderly post-fall.

What is Locked-In Syndrome?

Paralysis of all voluntary muscles except eyes; cognitive function intact

What are signs of PSH/storming

Increased HR, BP, RR, diaphoresis, posturing, hyperthermia

How is PSH/storming treated?

Medications, avoid triggers, calm environment.

Signs and common sites of HO?

Pain, swelling, reduced ROM. Hips, knees, elbows, shoulders.

Signs of CSF leak?

Clear drainage from nose/ears, vision/hearing changes

What triggers seizures post-TBI?

Missed meds, infection, lights, poor nutrition, stress

What are normal vs. abnormal ICP levels?

Normal: ≤15 mmHg. Increased ICP leads to decreased RR, HR

Vital sign pattern with ↑ ICP?

↑ BP, ↓ HR, ↓ RR.

Common medical treatments for TBI?

Glucocorticoids, antibiotics, surgery (craniotomy, burr holes).

What are the severity ranges of TBI by GCS?

Mild: 13–15, Moderate: 9–12, Severe: ≤8.

Components of the Glasgow Coma Scale

Eye response, verbal and motor response

What do higher vs lower CRS-R scores indicate?

Higher = cognitive responses; lower = reflexive responses.

What does RLA scale measure?

Cognitive and functional recovery level from I (coma) to VIII (independen

Common motor deficits post-TBI?

Weakness, tone changes, abnormal postures (decerebrate, decorticate), poor coordination.

What senses may be affected in a TBI

Touch, temperature, pain, position, vision, hearing.

Cognitive impairments from TBI?

Disorientation, memory loss, poor planning/problem-solving.

Examples of neurobehavioral changes?

Agitation, aggression, impulsivity, personality change

What are swallowing, speech, and talking complications with a TBI?

Aphasia, dysarthria, dysphagia

Name 5 interventions for TBI.

positioning, ROM, sensory stimulation, mobility training, strengthening

What is the positioning focus in early TBI care?

Neutral alignment, reflex inhibition, frequent repositioning (every 2 hrs).

What should a PTA do in a crisis situation?

Remain calm, remove triggers, redirect, protect all individuals.