TBI

  1. What is an acquired brain injury?

    • Damage to the brain acquired after birth

  2. What is the difference in traumatic vs. nontraumatic injury?

    • Traumatic: Caused by accidents, assaults, neurosurgery, falls, being struck by an object, or sports

    • Nontraumatic: Caused by stroke, tumor, infection, virus, poisoning, substance abuse, anoxia, or near drowning​

  3. Which is more common: traumatic or nontraumatic brain injury?

    • Traumatic brain injuries are more common

  4. What is a coup injury?

    • Coup injury: A direct brain injury that occurs at the site of impact when the head hits an obstacle

  5. What is a contrecoup injury?

    • Contrecoup injury: An injury that occurs on the side opposite the site of impact, often due to the brain rebounding within the skull​

  6. What is a diffuse axonal injury?

    • Diffuse axonal injury: Brain injury resulting from the brain moving back and forth within the skull, causing widespread axonal shearing

  7. How many are living in the US with long-term disability from brain injury?

    • Over 5 million Americans are living with long-term disability from brain injury​

  8. What ages are most affected?

    • Children, older adolescents, and adults aged 65+ are most affected by TBI

  9. Which gender is most affected?

    • Males are about 1.4 times more likely to experience a TBI than females​

  10. What is the leading cause of hospitalizations and ED visits due to TBI?

    • Falls are the leading cause of TBI hospitalizations and ED visits​

  11. After 1 TBI 🡪

    • 3x greater chance for a second TBI

  12. After 2 TBIs 🡪

    • 8x greater chance for a third TBI​

  13. Does ALL of the damage happen right at the time of injury? Or does the brain continue to be at risk?

    • The brain continues to be at risk due to secondary consequences following the injury​

  14. Primary consequences:

    • Examples: Contusions, lacerations, diffuse axonal injury, cranial nerve shearing, tearing of the pituitary stalk​

  15. Secondary consequences:

    • Examples: Intracranial hemorrhage, edema, neurochemical events leading to neuronal death​

  16. What is ICP? Why is it important to know the values?

    • ICP (Intracranial Pressure) refers to the pressure within the skull and brain tissues.

    • Normal adult pressure: 0-10 mm Hg

    • >20 mm Hg is abnormal

    • >40 mm Hg causes neurological dysfunction

    • >60 mm Hg is fatal​

  17. What is an EVD? What are the precautions associated?

    • EVD (External Ventricular Drain): A device used to drain cerebrospinal fluid from the brain to reduce intracranial pressure.

    • Precautions: Regular monitoring of drainage and positioning to prevent complications​

  18. Concussion (aka “mild TBI”):

    • Grade 1: Transient confusion, no LOC, cognitive symptoms <15 min

    • Grade 2: No LOC, cognitive symptoms >15 min

    • Grade 3: Definite LOC​

  19. Focal & Diffuse, Penetrating & Non-penetrating injuries:

  • Focal injury: Localized to one area of the brain​(Cog(21) Intro to TBI WO…).

  • Diffuse injury: Affects multiple areas​(Cog(21) Intro to TBI WO…).

  • Penetrating injury: Open head injury with dura mater breached​(Cog(21) Intro to TBI WO…).

  • Non-penetrating injury: Closed head injury​(Cog(21) Intro to TBI WO…).

20.  Mild brain injury (mTBI):

  • A TBI is classified as mild if mental confusion resolves within 24 hours, and LOC lasts less than 30 minute