Traumatic Brain Injury Flashcards

Flashcards about Traumatic Brain Injury (TBI)

What is a Traumatic Brain Injury (TBI)?

An alteration in brain function, or other evidence of brain pathology caused by an external force

What is the leading cause of TBIs?

Falls

What are the two major classifications of brain injuries?

Open and Closed Injuries

What are open head injuries?

Penetrating types of wounds where the skull can be either fractured or displaced.

What is a closed or intracranial injury?

An impact to the head, but the skull does not fracture or displace; Neural (brain) tissue is damaged, dura remains intact

What is a concussion?

A trauma that induces an alteration in mental status (physical and cognitive abilities) that may or may not involve a loss of consciousness

What are common symptoms of a concussion?

Dizziness, disorientation, blurred vision, difficulty in concentrating, alterations in sleep patterns, nausea, headache, and a loss of balance, amnesia

What is retrograde amnesia?

Loss of memory of the events before the injury

What is a coup lesion?

Contusion that occurs on the same side of the brain as the impact

What are contrecoup lesions?

Surface hemorrhages that occur on the opposite side of the trauma as a result of deceleration

What are Epidural hematomas?

Form between the dura mater and the skull and is frequently seen after a blow to the side of the head or severe trauma from a motor vehicle accident

What is a subdural hematoma?

Develops between the dura and the arachnoid; often seen in older adults after a fall with a blow to the head

What is an Anoxic Injury?

Oxygen deprivation for a period of time

What is a Diffuse Axonal Injury?

High velocity trauma that causes a strong rotational and translational force to brain tissue against the skull

What is locked-in syndrome?

Complete paralysis of all voluntary muscles except those that control eye movement

What is Second Impact Syndrome?

Individual receives a second injury before the symptoms of a first injury have resolved and typically involves a young athlete who returns to sport prematurely

What is a Blast Injury?

When an explosive device detonates, a transient shock wave is produced, which can cause brain damage; considered a signature injury of the U.S. military conflicts in the Middle East

What is a Secondary Brain Injury?

Result of a chain of cellular events that follow tissue damage in addition to the secondary effects of hypoxemia, hypotension, ischemia, edema, and elevated ICP

What is increased intracranial pressure (ICP)?

Common finding after a traumatic brain injury; can lead to compression of brain tissue, decreased perfusion of blood in brain tissues, and possible herniation

What are Seizures?

Discrete clinical events reflecting temporary, physiologic brain dysfunction, characterized by excessive hypersynchronous cortical neuron discharge

What is Heterotopic Ossification?

Abnormal bone formation in soft tissues and muscles surrounding joints that can occur after TBI and prolonged immobilization

What is Paroxysmal Sympathetic Hyperactivity (PSH)?

Consequence of severe traumatic brain injury that is associated with poorer outcomes

How do Cerebral Spinal Fluid Leaks occur?

High impact traumatic injuries, periods of increased intracranial pressure, the presence of skull fractures, and can be also be spontaneous

What is Arousal?

Primitive state of being awake or alert; reticular activating system is responsible for an individual’s level of arousal

What is Awareness?

Implies that an individual is conscious of internal and external environmental stimuli

What is Consciousness?

The state of being aware

What is a Coma?

Decreased level of awareness; state of unconsciousness in which the patient is neither aroused nor responsive to the internal or external environments

What is Stupor?

General unresponsiveness in which the patient is able to be aroused only after significant sensory stimulation

What is Obtundity?

People who sleep a great deal of the time; when individuals are aroused, they demonstrate disinterest in the environment and are slow to respond to sensory stimulation

What is a Vegetative State?

Demonstrates a return of brainstem reflexes and sleep-wake cycles yet remains unconscious

What is the Rancho Los Amigos Levels of Cognitive Functioning (LOCF) scale?

Descriptive scale used to examine cognitive and behavioral recovery in individuals with TBI as they emerge from coma

What is the difference between a concussion and a contusion?

A concussion is a trauma-induced alteration in mental status that may or may not involve loss of consciousness, while a contusion is a bruise to the brain, often affecting the frontal and temporal lobes. A contusion involves hemorrhages and tissue damage.

Which lobes of the brain are most frequently affected by a contusion?

Frontal and temporal lobes

What is the Glasgow Coma Scale?

A scale that evaluates a patient’s eye opening, best motor response, and best verbal response between 3 and 15. It is used to assess the level of consciousness after a TBI.

What is the acute management of a concussion?

The acute management of a concussion typically involves physical and cognitive rest. It's important to avoid activities that could lead to a second impact injury before the first one has healed. Symptoms should be closely monitored and managed. A graded return to activity protocol is often used.

What is Posttraumatic Amnesia (PTA)?

Inability to learn new information; the length of time between the injury and when the patient can consistently remember ongoing events.

What are the components of the Glasgow Coma Scale?

Eye Opening (E):
4 = Spontaneous: Open with spontaneous movement
3 = To Speech: Opens to verbal command
2 = To Pain: Opens to pain stimuli
1 = No Opening: No eye opening

Best Motor Response (M):
6 = Obeys Commands: Follows instructions
5 = Localizes Pain: Purposeful movements towards painful stimuli
4 = Withdraws from Pain: Withdraws from painful stimuli
3 = Abnormal Flexion: Decorticate posture in response to pain
2 = Abnormal Extension: Decerebrate posture in response to pain
1 = No Motor Response: No movement

What are the verbal responses in the Glasgow Coma Scale?

Best Verbal Response (V):
5 = Oriented: Knows who, where, and why
4 = Confused: Disoriented and converses, but is confused
3 = Inappropriate Words: Inappropriate words
2 = Incomprehensible Sounds: No understandable words
1 = No Verbal Response: No vocalization

What are the GCS scores for the different levels of brain injury?

Severe Brain Injury: GCS 3-8
Moderate Brain Injury: GCS 9-12
Mild Brain Injury: GCS 13-15

What is the Glasgow Coma Scale?

The Glasgow Coma Scale (GCS) is a scale that evaluates a patient’s eye opening, best motor response, and best verbal response between 3 and 15. It is used to assess the level of consciousness after a TBI.