TBI part one (study)

TBI

Focal injury

•limited to one area of the brain

Diffuse injury

•damage at multiple areas of the brain

Primary brain damage

occurs at the time of injury

• Coup contracoup injuries

• Cellular level (DAI: diffuse axonal injury)

Secondary brain damage

occurs within hours/days of initial injury

Chronic traumatic encephalopathy

•progressive, degenerative

Locked in Syndrome

•Patient is aware & awake

•Unable to move or communicate

•Can move eyes

what is Locked in Syndrome a resut of?

brain stem lesion

Focal Injuries

Damage to a specific location in the brain

•Contusion: visible bruising on the brain tissue

Diffuse Axonal Injuries

Occurs throughout the brain

•Shearing & tearing of neurons when the brain moves in the skull

•Damage to pathways connecting different parts of the brain

‒Messages in the brain are slowed or lost

People are _______ to have a 2nd TBI

3 times more likely

______ use significantly associated with increased risk of TBI

Alcohol

At least _____ of individuals with a TBI requiring rehabilitation were intoxicated at the time of their injury

45%

Shaken Baby Syndrome

Blood vessels between brain and skull rupture & bleed

Causes:

• Seizures

• Disability

• Coma

• Death

Low- & middle-income countries TBI

greater prevalence

Young males aged 15-25 years

highest demographic

‒Twice as likely than women to sustain a TBI

More diffuse: TBI

increased number of symptoms

More severe: TBI

higher the intensity & diversity of symptoms

Increased intracranial pressure: TBI diagnosis

• Swelling of the brain

Cerebral Hypoxia or Ischemia: TBI diagnosis

‒Blood vessels are ruptured or compressed

Intracranial hemorrhage: TBI diagnosis

‒Hypoxia to tissues that were fed by the hemorrhaging blood vessels

Electrolyte imbalance and acid-base imbalance: TBI diagnosis

‒Cell death by swelling or necrosis

TBI: Criteria A

‒Met for major or mild neurocognitive disorder

TBI: Criteria B

‒Loss of consciousness (LOC)

‒Posttraumatic amnesia

‒Disorientation & confusion

Neurological signs

TBI: Criteria C

neurocognitive disorder presents immediately after the occurrence

• persists past the acute post-injury period

Post concussion syndrome

includes physical, cognitive, sleep, & behavioral symptoms

• onset & have persisted 3 months or more

Second impact syndrome

a second concussion occurs before the first concussive symptoms resolve

•  altered mental status & sometimes LOC within seconds to minutes of the second hit

Even _______ can be life altering & cause long-term disability

mild injuries

• 80-90% of clients

Closed: TBI

does not penetrate the skull

• more common

Penetrating: TBI

–Caused by bullets or other objects piercing the brain

–Skull fracture & tearing of dura mater exposing brain tissue

People with TBI have a ____

reduced life expectancy by 9 years

Ranchos Los Amigos Scale

Track the stages of cognitive recovery from no response to independent functioning