Brain Injuries Flashcards
Traumatic Brain Injury ( TBI) Description and Definitions
-loss of consciousness, posttraumatic amnesia, disorientation and confusion, or, in more severe cases, neurological signs
* Complex changes in physical, cognitive, neurobehavioral due to
brain damage
* Damage occurs post birth
* Not associated to congenital or degenerative disease
Mild TBI:
- Loss of consciousness of <30 minutes
- Posttraumatic amnesia of <24 hours and disorientation and confusion
- Glasgow Coma Scale (GCS) score of 13 to 15.
Moderate TBI
- Loss of consciousness of 30 minutes to 24 hours
- Posttraumatic amnesia of 24 hours to 7 days
- GCS score of 9 to 12
Severe TBI:
Loss of consciousness of more than 24 hours
* Posttraumatic amnesia of more than 7 days
* GCS score of 3 to 8 (American Psychiatric Association, 2013)
Primary brain damage
Focal lesions
Diffuse lesions
Diffuse lesions
- Occur throughout multiple brain areas and may result from an explosion, motor
vehicle accidents, or sport collisions. Often at speeds of 15mph or more. - Motor vehicle accidents typically result in both coup and contrecoup injuries
Focal lesions
- Limited in scope and are associated with direct impact of short duration such as occurs with gunshot
- Occurs throughout multiple brain areas and may result from an explosion, motor vehicle accidents, or sport collisions
Secondary damage
Occurs within hours and days of impact. Factors leading to secondary damage may include inflammatory responses, raised intracranial pressure, and decreased cerebral blood flow or
ischemia
General Medical Complications
1st wk symptoms following mild TBI: dizziness, fatigue, memory difficulties, headaches
* Coma
* Hydrocephalus -Buildup of fluid in the cavities ands pressure
-Seizures
-Deep vein thrombosis following TBI is up to 54%
-Dysautonomia - severe TBI
TBI Etiology
Falls (most common)
Motor vehicle accidents (most common severe TBI)
Violence
* TBI ER visits most common below the age 5 and > age 85
* 61% of vehicle accidents involved males
* 1/3 to 1/2 intoxicated time of injury
Diagnostic Testing
- Glasgow Coma Scale (GCS)
- Disability Rating Scale (DRS) – expanded on GCS info; good validity &
reliability - Rancho Los Amigos Scale, aka Levels of Cognitive Functioning
- CT scan & MRI
TBI
- Physical
- Cognitive
- Communicative
- Neurobehavioral changes.
-all different
-Impact all Occupational performance
Diagnostic Testing: Glasgow Coma Scale
Rating of:
* Eye opening,
* Motor responses, &
* Verbal responses
*To assess level of consciousness
*Used to quantify severity of brain injury & predict outcome
*Beset known & widely accepted scale of coma
Cerebellar or intention tremors
-slow tremors that occur at the end of purposeful movement associated with ataxia,hypotonia, and balance disorders
-occur in trunk-
-4-6 sec
-Resting tremors
Correlated with striatal damage and involve a pill-rolling movement at rest, occurring at a
similar rate
Essential tremors
Slow constant tremors that typically affect more distal musculature, occur at a frequency of 8 to 12 per second, and increase with anxiety and maintained positions.