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III. Clinical Binocular Vision > Acquired Brain Injury (F) > Flashcards

Acquired Brain Injury (F) Flashcards

1
Q

What is damage to the brain, which occurs after birth and is not related to a congenital or degenerative disease?

A

acquired brain injury (ABI)

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2
Q

What are the types of closed head TBIs?

A
  1. Blunt trauma with deflection of skull but no fracture
  2. Coup-Contrecoup injury
  3. Diffuse Axonal Injury (DAI)
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3
Q

What is the Glasgow Coma Scale score for a mild TBI? 1. What is the survival rate? 2

A
  1. 13 to 15

2. 99.6%

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4
Q

What is the Glasgow Coma Scale score for a moderate TBI? 1. What is the survival rate? 2

A
  1. 9 to 12

2. 93%

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5
Q

What is the Glasgow Coma Scale score for a severe TBI? 1. What is the survival rate? 2

A
  1. 3 to 8

2. 42%

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6
Q

What is the OSU TBI ID survey severity score for no TBI? 1. Mild TBI (with description)? 2. Moderate TBI (with description)? 3. Severe TBI (with description)? 4

A
  1. 1
  2. 2 (dazed or memory lapse but no LOC) or 3 (LOC less than 30min)
  3. 4 (LOC btw 30min and 24hrs)
  4. 5 (LOC over 24 hrs)
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7
Q

What is the criteria to be considered a mild traumatic brain injury (mTBI) by the WHO?

A

Closed acute brain injury resulting from mechanical energy to the head from external physical force with the following:

  1. One or more of the following: Confusion or disorientation, Loss of consciousness for 30min or less, Post traumatic amnesia for less than 24hrs, Other transient neurologic abnormalities
  2. GCS score of 13 to 15 30min after injury
  3. exclusion of other mental and physical causes
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8
Q

What is the leading cause of TBI for active military personnel in war zones?

A

blasts

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9
Q

What is the type of TBI that a concussion is considered? 1. What are the typical neuroimaging findings? 2

A
  1. mTBI

2. normal structural neruoimaging findings

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10
Q

What type of TBI are marked by symptoms that include headache, dizziness, hearing problems, visual disturbances, noise or light sensitivity, sleep disturbance, and emotional or mental fatigue?

A

somatic

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11
Q

What type of TBI are marked by symptoms that include problems with thinking, making decisions, memory, attention and concentration, abstract reasoning, and information processing?

A

cognitive

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12
Q

What type of TBI are marked by symptoms that include depression, anxiety, mood swings, irritability, impulsiveness, loss of interest, agitation, and relationship difficulties?

A

psychological

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13
Q

What score on the Brain Injury Vision Symptom Survey (BIVSS) indicates significant visual problems?

A

45 or greater

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14
Q

What are the typical ocular symptoms of a TBI?

A
  1. blurred vision
  2. diplopia
  3. asthenopia
  4. light sensitivity
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15
Q

What are some of the areas impacted by damage from a TBI to the frontal lobe?

A
  1. Disinhibition/emotions
  2. Reasoning
  3. Saccadic control
  4. Reduced blink rate
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16
Q

What are some of the areas impacted by damage from a TBI to the temporal lobe?

A
  1. Memory
  2. Visual processing
  3. Visual field deficits
  4. Speech / language deficits
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17
Q

What are some of the areas impacted by damage from a TBI to the occipital lobe?

A
  1. Cortical visual impairment / blindness

2. Homonymous field defects

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18
Q

What are some of the areas impacted by damage from a TBI to the parietal lobe?

A
  1. Visual field deficits
  2. Visual perceptual deficits / neglect
  3. Movement
  4. Orientation
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19
Q

What are some of the areas impacted by damage from a TBI to the brainstem?

A
  1. Balance
  2. Cranial nerves associated with EOMs, blinking, and pupils
  3. Difficulty with balance, dizziness, nausea
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20
Q

What are some of the areas impacted by damage from a TBI to the cerebellum?

A
  1. Coordination of movement
  2. Disturbances in visual motor coordination
  3. Nystagmus
21
Q

What are the oculomotor tests that should be done for a TBI?

A
  1. DEM
  2. NSUCO
  3. visagraph
22
Q

What are the strabismus tests that should be done for a TBI?

A
  1. comitancy

2. Park’s

23
Q

What are the seven most important tests for a mTBI patient?

A
  1. distance cover test
  2. near cover test
  3. versions (EOMs) and or pursuits
  4. accommodation
  5. saccades
  6. NPC
  7. repeated NPC
24
Q

What is defined as rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours of longer or leading to death, with no apparent cause other than of vascular origin?

A

cerebrovascular accident

25
Q

What are the types of cerebrovascular accidents?

A
  1. ischemic

2. hemorrhagic

26
Q

What are the etiologies of an ischemic CVA?

A
  1. Atherosclerosis
  2. Embolism from heart
    3 Intracranial vasculitis
    4 Increased blood viscosity
    5 Complicated migraine
    6 Hypertensive arteriolar disease
    7 Fibromuscular dysplasia
    8 Carotid dissection
27
Q

What are the etiologies of an hemorrhagic CVA?

A 
1 Hypertension
2 Saccular aneurysm
3 Arteriovenous malformation
4 Anticoagulant therapy
5 Bleeding dyscrasias
6 Hemorrhage into brain tumor
7 Idiopathic
28
Q

What are the most common visual sequellae of CVA in order of most common?

A
  1. eye alignment or movement impariment
  2. visual field impairment
  3. low vision
  4. perceptual difficulties
29
Q

What is impairment of language affecting the production or comprehension of speech and the ability to read or write?

A

aphasia

30
Q

What is the type of aphasia in which the patient can produce few recognizable words and understand little or no spoken language?

A

global aphasia

31
Q

What is the type of aphasia in which the patient can’t get out what they want to say? 1. What Brodmann areas are these? 2. In which lobe? 3

A
  1. Broca’s aphasia (non fluent aphasia)
  2. 44 and 45
  3. left frontal lobe
32
Q

What is the type of aphasia in which the patient can only speak jargin? 1. What Brodmann areas are these? 2. In which lobe? 3

A
  1. Wernicke’s aphasia (fluent aphasia)
  2. 21 and 42
  3. left temporal lobe
33
Q

What are the most common causes of homonymous hemianopia in order?

A
  1. stroke
  2. tumors
  3. trauma
34
Q

Does a homonymous hemianopsia usually improve (and when)? 1. How long until improvement is not likely? 2

A
  1. yes (3 months)

2. 6 months

35
Q

What is the therapy to improve a homonymous hemianopsia called? 1. What is the software to do this? 2. Is it effective? 3

A
  1. vision restoration therapy (VRT)
  2. NovaVision
  3. no
36
Q

What is it called when a person does not draw a certain portion (like the entire left side) of all objects that they are attempting to copy? 1. What is a possible treatment to help with this? 2

A
  1. visual spatial neglect

2. yolked prism

37
Q

If a patient has left visual spatial neglect, what type of yolked prism should be given to them?

A

30pd base left

38
Q

What are the quantitative measured outcomes of yoked prism therapy? 1. Qualitative? 2

A
  1. blind pointing and increased scanning

2. improved pen and paper exercises and improved ADL

39
Q

What are good pen and paper tests for visual spatial neglect?

A
  1. spontaneous drawing (clock)
  2. copying (flower, house)
  3. star cancellation test
  4. line bisection
40
Q

What is the type of hemispatial neglect in which it is applied to the patients own body? 1. The space within arm’s reach of person? 2. Space beyond arm’s reach? 3

A
  1. personal
  2. peripersonal
  3. extrapersonal
41
Q

What are the two orientation networks in the brain?

A
  1. dorsal frontoparietal network (DFPN)

2. ventral frontoparietal network (VFPN)

42
Q

What is the theory of how hemispatial neglect develops involving the orientation networks?

A
  1. Damage to the R VFPN causes a global drop in function and a hypoactivation of the R parietal cortex
  2. The hypoactivation of the R DFPN causes reduced inhibition and leads to dominance of the L DFPN
  3. Dominance of the L DFPN causes hyperattention to the right field and NEGLECT of the left field.
43
Q

What is the classic triad of Gradenigo’s syndrome?

A
  1. suppurative otitis media (otorrhea)
  2. pain in the distribution of the trigeminal nerve (headache)
  3. abducens nerve palsy (diplopia)
44
Q

What is an abnormal regeneration process following paralysis or paresis of the fibers of CN III in which the upper lid fails to follow the eye on downward gaze or even retracts on downward gaze or adduction, with occasional contraction of the pupil called?

A

aberrant regeneration (oculomotor synkinesis)

45
Q

What is characterized by rhythmic movements of the soft palate, pharynx, and larynx? 1. What is it called if combined with a vertical pendular nystagmus? 2

A
  1. palatal myoclonus

2. oculopalatal myoclonus

46
Q

What is the cause of oculopalatal myoclonus?

A

Lesion in Triangle of Guillain and Mollaret

47
Q

What results from occlusion of an arterial branch of the proximal posterior cerebral artery located immediately following its take-off from the basilar artery and prior to its junction with the posterior communication artery?

A

supranuclear vertical ophthalmoplegia (SVO)

48
Q

What is the most common acute cause of a supranuclear vertical ophthalmoplegia (SVO)? 1. What are infarcts in this region a result of? 2

A
  1. thalamic lesion

2. systemic hypotension, posterior circulation emboli, dissection, or neurosurgical procedures

III. Clinical Binocular Vision (15 decks)

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