Traumatic Brain Injury

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16 Terms

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What is a TBI?

Damage to the brain that occurs as a result of an external and forceful event

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What populations are most at risk for a TBI?

  • 4 and under

  • 75 and over

  • Adolescent males

  • Drug and alcohol users

  • Previous TBI patients

  • Law enforcement

  • Low socioeconomic status

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Closed head injury

Trauma to the brain with the skull remaining intact

  • Considered diffuse (brain shaken around)

  • Often involved Acceleration/Deceleration injures

  • mTBI (concussion)

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Coup Contre Coup

First and second point of impact

  • Can be any direction with any lobe impacted

  • The areas of the brain that show damage

    • bleeding or bruising

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mTBI

AKA concussion

  • Period of confusion following impact with or without loss of consciousness

  • Symptoms may go unrecognized

  • May result in physical/cognitive/social/emotional deficits

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Diffuse Axonal Injury

  • Shearing and tearing of long axons and neural connections

  • Due to high levels of force in coup contrecoup injuries

    • acceleration/deacceleration

  • Results in generalized damage to the brain and brainstem

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Impact based TBI

  • Injury to the brain that occurs as a result of a stationary head being impacted by a moving object

    • Ex: violent assault

  • The skull is forced inwards where the impact is = force on the brain

  • Compressive forces may bruise or tear the brain surface

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Open head TBI

Injury that penetrates the skull into the brain

  • Gun shot wounds

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Secondary mechanisms of damage are:

  • Increased intracranial pressure (ICP)

    • the brain becomes compressed

  • Cerebral swelling - edema

    • brain tissue swelling as a result of trauma that may increase ICP

  • Shaken baby syndrome

  • Military & Sports

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What is the Glasgow Coma Sclae?

Assessment of severity of injury to the brain

  • not used to assess the level of coma or arousal

  • done in 3 parameters

    • motor, verbal, eye-opening

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Coma

  • Deep unconsciousness

  • No responses or sleep wake cycles

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Vegetative state

  • Inbetween state

  • May or may not be permanent

  • Sleep wake cycles are present

  • Generalized responses

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Minimally conscious state

  • localized responses

  • Sleep-wake cycles are not consistent

  • May follow commands unconsiously

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Post-traumatic amnesia (PTA)

  • A period of time or recovery

  • Confusion and disorientation of past/present

  • Recovery for individuals from comas and vegetative states

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Describe Rancho Los Amigos

  • A test of cognitive/behavioral recovery from TBI

  • An individual may start at any level and may not go through all stages

  • Used to asses a persons level of recovery patterns

  • 10 pt scale - coma to independent

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Cognitive deficits

Affects:

  • Orientation

  • attention

  • memory

  • problem solving

  • Personality changes

  • impulsivity

  • motivation

  • emotional lability