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02 - Neuro - Conditions > Brain Injuries > Flashcards

Brain Injuries Flashcards

1
Q

Types

A 
> Traumatic 
> Non - Traumatic
- Stroke
- infection
- surgical complication
- anoxia
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2
Q

Facts

A

> ~ 350,000 in UK
more common in males (females numbers are on the rise)
TBI increased by 6% in last 15 years
Peak risk is 16-25yr olds or over 65’s

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3
Q

Traumatic Brain Injury

  • Definition
  • Causes
A

> Injury to the brain via trauma to the head

> Causes

  • Automobile accident
  • slipping/falling
  • something striking the head
  • being shaken violently
  • sports
  • violence
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4
Q

Traumatic brain injury - closed head injuries

A

> Brain is traumatized inside the skull (majority)
Diffuse axonal injury = accel + deccel of brain on skull
(‘coup-contracoup’ injury or rattling of brain)
- white + grey matter are different densities so travel at different speeds = shearing force at boundary
- Primary = shear
- Secondary = chemical/swelling damage to axon + demyelination
Concussion = temporary disruption of brain function
Intracranial haematoma = ruptured vessel causes pool of blood around brain or between brain + skull
Cerebral Contusion = bleeding in brain

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5
Q

Traumatic Brain Injuries

  • Open wound injuries
  • Crushing injuries
A

> Open wound injuries

  • blow to head is forceful enough to penetrate the skull
  • often life-threatening
  • potential for infection

> Crushing injuries

  • brain is compressed between two objects
  • very life threatening (rarest of brain injuries)
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6
Q

Traumatic Brain Injury - Signs + Symptoms

A 
> Difficulty concentrating or confusion
> Changes in consciousness
> Headaches + dizziness
> Vomiting + Nausea
> Changes in mood/personality/behaviour
> Changes in eyes/dilated pupils
> Changes in vision - blurred vision/hallucinations
> Swelling at site of brain injury 
> Inability to remember 
> Difficulty breathing
> fluid leaking from nose/ears/eyes = CSF 
> Difficulty with speech
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7
Q

Traumatic Brain Injuries - Severity

A 
> dictated by:
a) loss of consciousness
b) post traumatic amnesia 
> Minor 
a) <15mins
b) < 1 hour 
> Moderate 
a) 15mins - 6hrs
b) 1-24hrs
> Severe
a)  6-48 hours 
b) 24hrs - 7 days
> V. severe
a) 48 hours + 
b) 7 days +
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8
Q

Coma + Reduced Awareness states

A

> Vegetative

  • brainstem = functioning
  • sleep - wake cycles
  • no conscious awareness of themselves or their surroundings

> Minimally Conscious

  • Distinct but limited signs of awareness - will respond to stimuli
  • v. difficult to remain aware or responsive for a predictable amount of time

> Locked in Syndrome

  • Aware of themselves + surroundings
  • unable to move/speak (can communicate via blinking)
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9
Q

Anoxic Brain Injuries - Definition

A

> Non- traumatic
Brain is deprived of oxygen (neural cells begin to die = apoptosis)
If enough cells die (large amount) then there is diminished brain function

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10
Q

Anoxic Brain Injuries - Causes

A 
> Stroke or TIA
> Anaphylactic shock
> Electrocution
> Extremely low blood pressure 
> severe pneumothorax/collapsed lung
> O2 deprivation at birth 
> Choking or strike to windpipe
> Drug Overdose
  • Brain damage = possible after 30 secs without O2
  • almost inevitable after 2 mins
  • brain death can occur after 4 mins without O2
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11
Q

Anoxic brain injuries - Types

A

> Diffuse Cerebral Hypoxia
- mild to moderate injury
- minimal brain impairment due to low blood O2
Focal Cerebral Ischaemia
- O2 deprivation (usually due to stroke) to a single brain region
- Other regions may be unaffected
Global Cerebral Ischaemia
- Complete cessation of blood to brain = v. damaging
Cerebral Infarction
- Stroke completely deprives multiple brain regions of O2

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12
Q

Anoxic Brain Injuries - Immediate Signs + Symptoms

A 
> Confusion
> Loss of consciousness
> Feeling woozy/dizzy
> Intense headache
> Vomiting
> Changes in behaviour 
> Changes in sensation (tingly/numb)
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13
Q

Signs + Symptoms of all brain injuries

A

> Depend on area affected

> Can affect all four limbs

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14
Q

Damage to Frontal Lobe

A
  • Decision Making + Problem Solving
  • Attention
  • verbal expression
    > Movement
  • sequencing
  • lack of spontaneity
  • movement initiation
    > Emotional Control + Personality changes
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15
Q

Damage to Temporal Lobe

A 
> Speech 
- Understanding speech 
- Inhibition - constantly talking
> Identification/Categorization/Location/Recognition of objects, faces etc.
> Selective Attention
> Sexuality Changes
> Aggressive Behaviour
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16
Q

Damage to Parietal Lobe

A

> Object classification
Tactile sensation processing
Decreased cognitive ability + academic skills
Worse proprioception (hand-eye co-ordination decreases)

17
Q

Damage to Occipital Lobe

A 
> Vision/Visual field changes 
- difficulty locating objects 
- identifying colours
- hallucinations
- movement perception
- visual processing (word blindness)
> Issues reading/writing
18
Q

Damage to Cerebellum

A

> Control of movement

  • co-ordination
  • voluntary motor skills
  • balance
  • posture
  • eye movement
19
Q

Brain Stem

A

> Autonomic Control

  • Body temp
  • heart rate
  • breathing
  • balance
  • movement
  • swallowing
  • Vertigo/dizziness/nausea symptoms
20
Q

Tests for brain injuries

A

> Angiogram (X-ray after dye put in system - detect blockages)
blood tests
CT scan
Echocardiogram (ultrasound of heart)
Electrocardiogram - ECG - measures hearts electrical activity
Electroencephalogram - identify seizures + how cells work
evoked potentials - whether certain sensations reach brain
MRI of head

21
Q

Immediate management

A

> breathing assistance - mechanical ventilation
Controlling heart rate + rhythm
Raise blood pressure if low
Calm seizures (due to pressure build up/fluid around brain tissue)

22
Q

Medications

A

> Anticonvulsants - seizures (gabapentin/carbamazepine)
Antidepressants - anxiety/chronic pain/depression
Antipsychotics- aggression/sleep disorders
Pain management
Anti-spasmodics - baclofen/tizanidine
Memory + attention drugs

23
Q

Prognosis

A

> Lower glasgow coma scale = higher mortality risk
prognosis declines with age
location of contusion
length of time in coma + time of post-traumatic amnesia

24
Q

Treatment for behaviour changes

A 
> Relaxation 
- breathing techniques
- laura mitchell technique 
- visualisation 
> Mindulness
> SMART goals 
> Cognitive Behavioural Therapy

02 - Neuro - Conditions (4 decks)

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