11 - Traumatic brain injury

Question 1

Can a head concussion be considered a TBI?

Answer 1

Yes (mild TBI)

Question 2

Definition of traumatic brain injury

Answer 2

Defined as a physical injury to brain tissue that temporarily or permanently impairs brain function

Question 3

TBI is caused by external mechanical forces such as: (2)

Answer 3

• A direct blow to the head by blunt of penetrating object
• Indirect forces such as inertia, where rapid movement of the head causes back and forth movement of the brain inside the skull

Question 4

TBI classified based on 2 things

Answer 4

1. Severity (mild, moderate, severe)

2. Mechanism of injury (closed or penetrating head injury)

Question 5

Depending on the severity, TBI can affect numerous aspects such as (5)

Answer 5

Physical capability
Cognitive ability
Emotional state
Social interactions
Behavior

Question 6

After a TBI, there is an increase risk of (3)

Answer 6

Epilepsy, Alzheimer’s disease and Parkinson’s disease

Question 7

Can the side of brain lesions predict the type of impairments and disabilities following TBI?

Answer 7

YES

Question 8

Leading cause of death and disability for people under 35 yo

Answer 8

Traumatic brain injury

Question 9

Incidence of TBI (w vs m)

Answer 9

78,8% MEN vs 21,2% WOMEN

Question 10

65 000 new cases every year in Canada, of these:

• 20% ___
• 10 to 20% ____
• And the the others (50%) ____

Answer 10

Die
Survive with severe impairments, no independent living
Learn to live with various disorders

Question 11

Incidence of TBI (age group)

Answer 11

1 is the 15-24 years old

Question 12

Incidence (sports vs assaults vs motor vehicle)

Answer 12

20% sports
9% assault
28% motor vehicle

Question 13

2 types of TBI

Answer 13

Penetrating head injury

“Closed head” injury

Question 14

Penetrating head injury

Answer 14

Where brain tissue is damaged by an object such as a knife, a bullet or bone fragments that has pierced the skull and dura mater

Question 15

Closed head injury

Answer 15

Injury in which the skull and dura mater are not breached

Question 16

When there is damage at both sides of impact

Answer 16

Coup contre-coup injury

Question 17

TBI damage can also be described as (2 categories)

Answer 17

focal or diffuse

Question 18

focal injury

Answer 18

Injury confined to a specific area of the brain causing localized damage

Question 19

diffuse injury

Answer 19

Injury is characterized by damage throughout the brain

Question 20

Causes of TBI (4)

Answer 20

Hematoma
Hemorrhage
Diffuse axonal injury
Contusions

Question 21

What happens during a TBI? (2 things)

Answer 21

• Nerve fibers within specific areas of the brain are severed
• Nerve fibers are stretched which results in inefficient and slowed functioning

Question 22

Hematoma

Answer 22

Collection of blood outside blood vessels

Question 23

Intracerebral hematoma

Answer 23

Bleeding within the brain tissue itself

Question 24

Subdural hematoma

Answer 24

Bleeding can occur outside the brain

Question 25

Hemorrhage

Answer 25

Bleeding directly into brain tissue

Question 26

Diffuse axonal injury

Answer 26

Results from a tearing of nerve bundles and/or stretching of blood vessels

Question 27

Contusions

Answer 27

Bruises that cause swelling and bleeding resulting in tissue damage

Question 28

Coup

Answer 28

brain injury at the point of impact (primary impact)

Question 29

Contrecoup

Answer 29

brain injury is opposite to the point of contact (secondary impact)

Question 30

Hemineglect syndrome

Answer 30

Right parietal lobe damage (like the left side of the world doesn't exist for the person, ex: clock drawing)

Question 31

Degrees of severity

Answer 31

1. Confusion 2. Coma 3. Cerebral death

Question 32

Confusion (a clouding of consciousness)

Answer 32

Thinking process is decreased Inattention, disorientation Speech is affected

Question 33

Coma (cannot be aroused by strong sensory stimuli)

Answer 33

Can affect IQ Decrease metabolic activity of the brain (no sleep) Lead to amnesia

Question 34

Cerebral death (the body is alive but not the brain)

Answer 34

The brain is no longer able to regulate body function

Question 35

TBI symptoms - Medical

Answer 35

Headaches, risk of seizures, changes in appetite, fatigue (both mental and physical)

Question 36

TBI symptoms - Physical

Answer 36

Balance issues, lack of coordination, muscle weakness or paralysis, muscle rigidity/spasticity

Question 37

TBI symptoms - Senses

Answer 37

Over-sensitivity, vision problems, sensitivity to noise, changes to sense of smell and taste, single-sided neglect

Question 38

TBI symptoms - Thoughts and communication

Answer 38

Can affect organization of thoughts or ability to find words and communicate clearly

Question 39

TBI symptoms - Behavior and personality

Answer 39

Irritability or mood swings, depression, anxiety, agitation, impaired judgment, lack of insight or awareness of problems, trouble sleeping

Question 40

Difference between effects of TBI and stroke on body functions

Answer 40

Brain damage after TBI is more widespread than stroke

Question 41

Can the recovery process occur for more than 2 years post TBI?

Answer 41

YES, recovery process may take more than 2 years

Question 42

Is there a relation between length of coma and level of motor severity?

Answer 42

Yes, longer the coma, greater the motor severity