Week 8.2 Intro to ABI

Understand the pathogenesis of traumatic brain injury

• primarily injury due to result of traumatic force

• secondary Injury happens after the initial injury and impacts tissue that was not initially injured.

examples of secondary conditions

• Ischemic

• hypoxic damage

• cerebral edema

• hydrocephalus

• infection

Altered States of Consciousness from least to most severe

1. Clouding of consciousness: confused

2. Delirium: agitated

3. Obtundity

4. Stupor

5. Persistent vegetative state: Wakeful but unresponsive,

6. Coma: Unresponsive

Decorticate posturing

“Towards the core” essentially a flexing synergy

• Plumber’s dad knockout

dEcerebrate posturing

the “E” is for extension synergy

3 tests of consciousness in the context of traumatic brain injury

1. Glasgow Coma Scale (GCS)

2. Post Traumatic Amnesia (PTA) duration

3. Rancho Los Amigos Hospital Levels of Cognitive Functioning (RLAS-10)

Glasgow Coma Scale score range

• 13-15 = Mild TBI (minor deficits and they are alert/responsive)

• 9-12 = Moderate TBI

• 8 or less = Severe TBI (impaired consciousness)

• 3 = coma

Post Traumatic Amnesia (PTA) scale

• Less than 1 hour = Mild

• 1 day = Moderate

• 1 week = Severe

• More than 1 week = Very severe

Ranchos Los Amigos Cognitive

Assessment (RLAS-10)

is a 10-level tool that tracks how alert and aware brain injury patients are as they recover

scaling of the is a 10-level in the RLAS-10

• Levels 1-3: Minimal awareness, total assistance.

• Levels 4-5: Confused, significant assistance needed.

• Level 6: More appropriate responses, moderate assistance.

• Levels 7-8: Increasing independence in daily activities.

• Levels 9-10: Near-independent to moderately independent function.

most commonly used scale for levels of consciousness

Glasgow Coma Scale

2 serious forms of acquired brain injury

Meningitis and encephalitis