MTBI and Anoxia Lecture Review

This set of vocabulary flashcards covers the definitions, physiological mechanisms, clinical trajectories, and neuropathology associated with mild Traumatic Brain Injury (mTBI/Concussion) and Anoxia.

MTBI (Concussion) GCS Score

A Glasgow Coma Scale (GCS) score ranging from $13-15$.

LOC in Concussion

Loss of consciousness that is not required for diagnosis, but if present, is not over $30\,\text{mins}$.

PTA in mTBI

Post-traumatic amnesia and altered mental state lasting $<24\,\text{hours}$.

Post-concussive syndrome

A condition occurring in $10-20\%$ of cases where residual deficits last months to years.

Metabolic Cascade

A functional injury process involving excitatory neurotransmitter release, abnormal ion fluxes, increased glucose metabolism, and lactic acid accumulation leading to inflammation.

Cerebral Autoregulation

The "tone" of arteries to maintain perfusion; $20-30\%$ of individuals with mTBI experience dysregulation of this system.

Second Impact Syndrome (SIS)

A life-threatening condition where a second injury occurs after a concussion (without hematoma), causing a catecholamine surge and profound brain swelling.

ImPACT

Immediate Post-concussion Assessment and Cognitive Testing; used to track recovery by measuring attention span, memory, and reaction time.

SAC

Standardized Assessment of Concussion; a brief sideline test used minutes post-injury.

Computerized Posturography

Balance assessment tools such as the Neurocom SOT and BESS.

Cognitive / Fatigue Trajectory

A concussion profile characterized by poor concentration, reduced processing speed, and normal vestibular and balance exams.

Post-traumatic Migraine Trajectory

A clinical picture including symptoms of nausea, photophobia, and sound sensitivity, often exacerbated by stress.

Cervical Trajectory

Characterized by neck pain, stiffness, and occipital headaches, with noted decreased cervical range of motion (ROM).

Vestibular Trajectory

Characterized by dizziness, nausea, and balance problems that worsen with head movement or busy environments.

Ocular Trajectory

A clinical picture involving frontal headaches, nystagmus, and difficulty with tracking objects or watching screens.

BDNF

A neuroprotective protein released during sub-symptom threshold aerobic exercise that enhances recovery.

Anoxia Watershed Areas

Border zones at the end of vascular distribution highly susceptible to damage: $\text{ACA-MCA}$, $\text{MCA-PCA}$, and intermediate branches.

Hippocampus in Anoxia

The most common gray matter structure involved, leading to deficits in short-term memory (STM), declarative memory, and amnesia.

Basal Ganglia involvement

Damage to the Globus Pallidus in anoxic injury results in paralysis, extra-pyramidal signs, and Parkinsonism traits.

Alien Hand Syndrome

A potential result of damage to the Corpus Callosum, the largest white matter tract in the nervous system.

Wallerian Degeneration

The breakdown and atrophy of white matter pathways following injury, commonly affecting the fornix and mammillary bodies.

Global Generalized Cerebral Atrophy

Diffuse damage occurring $1-2\,\text{years}$ post-anoxic injury where cortical sulci shrink and ventricular volumes increase.