11.4 Cognitive-Communicative Impairments Flashcards
common to all TBI survivors
reduced ability to pursue pre-injury career and lesser activities
impairment is usually due to
cognitive impairments - attention, memory, organizing, communication, social skills, pre injury abilities
what can help a patient attain pre injury status?
personality
pre injury abilities
severity of TBI
support system
with TBI there is a complex constellation of
motor, sensory, psychological, emotional, cognitive and communicative symptoms
coma
state of unconsciousness, eyes closed, to does not wake
coma is usually due to
brainstem lesions and thalamic lesions
- persistent severe diffuse injury to cortex and subcortical regions
persistent vegetative state
can be aroused but don’t have any higher functions; lasted at least a month
minimally conscious state
often transitional and reflects improvement in consciousness
cognitive impairments can affect
- orientation (frontal lobe)
- attention/concentration
- memory
- executive function
- anosognosia
- behavioral disorders
orientation
frontal lobe
- awareness of person, place, time, circumstance, situation
- post traumatic amnesia
attention/concentration
- focused att
- sustained att
- selective att
- alternative att
- divided att
memory
hippocampal, thalamic, frontal
- requires intact encoding, storage, consolidation, recall
- long term memory
- working mem
- short term mem
long term memory is
explicit/declarative memory
implicit/non-declarative
working memory
the memory that temporarily holds and manipulates info
short term memory
the temporary memory of small amount of information
with TBI memory deficits are
common and likely due to different factors
- reduced attn/distractibility
- slower info processing
- reduced organized
- reduced foresight
executive functioning
prefrontal cortex and related cortical/subcortical pathways
- planning
- judgement
- decision making
- anticipation
processes also involve memory, planning, flexibility, reasoning, self-monitoring
anosognosia
40% of individuals with TBI
more common with cortical s. subcortical
more common with anterior and frontal lesions
behavioral disorders
disinhibition irritability agression inappropriate sexual behaviors anger awkwardness immaturity depression egocentrism social withdrawal
