Brain injury Flashcards
most important risk factor for stroke
age
MOST IMPORTANT MODIFIABLE RISK FACTOR FOR STROKE
HYPERTENSION
MOST COMMON ETIOLOGY FOR TBI
FALL
MOST COMMON AREA FOR CONTUSION
INFERIOR FRONTAL LOBE AND ANTERIOR TEMPORAL LOBE
DAI
WHAT IS?
COMMON LOCATION
DISRUPTION OF THE AXON DUE TO ACCELERATION/DECELERATION. ASSOC WITH LOC.
CORPUS CALLOSUM, CENTRAL WHITE MATTER AND MIDBRAIN (WORST PROGNOSIS)
PRIMARY INJURY AFTER TBI
DAI AND CONTUSION
PLASTICITY
CAPABILITY IF DAMAGED BRAIN TO REPAIR VIA TWO MECHANISMS
SPROUTING: INTACT AXONS STABLISH CONNECTION IN DAMAGED AREAS
UNMASKING NEURAL REORGANIZATION: HEALTHY STRUCTURE ARE REASSIGNED TO DO FUNTIONS SUBSERVED BY THE LESIONED AREA.
P:US
DIASCHISIS
EXPLAINS SPONTANEOUS RETURN OF FUNCTION. LESION TO ONE REGION CAN PRODUCE ALTERED FUNCTION IN OTHER AREAS OF THE BRAIN IF THERE IS A CONNECTION.
COMA
LACK WAKEFULNESS IN EEG. RESULTS FROM THE DAMAGE TO THE RAS IN THE BRAINSTEM OR ITS CONNECTIONS.
VEGETATIVE STATE
SLEEP-WAKE CYCLE ON EEG. NO AWARENESS
MINIMALLY CONSCIOUS STATE
ENVIRONMENTAL AWARENESS. PURPOSEFUL BEHAVIOR.
BEST PREDICTOR OF GCS
MOTOR RESPONSE
OUT OF PTA IF…
GOAT 75 OR HIGHER FOR TWO CONSECUTIVE DAYS
RLA IV
CONFUSED AND AGITATED
RLA V
CONFUSED, NON-AGITATED, INAPPROPRIATE
MAJORITY OF PTS ARE
SIMPLE PARTIAL
RISK FACTORS FOR LATE PTS
PENETRATING HEAD INJURY, EARLY PTS, ICH, DEPRESSED SKULL FRACTURE, PROLONGED COMA OR PTA >24HRS, BITEMPORAL LESIONS, AGE, ALCOHOL, TCAs, FOREIGN BODIES, APHASIA, HEMIPLEGIA.
PROPHYLAXIS OF PTS
7 DAYS POST INJURY (PREVENT ONLY EARLY PTS) WITH PHENYTOIN OR VALPROIC ACID.
PTS TREATMENT
VALPROIC ACID (GENERALIZED SEIZURE), CARBAMAZEPINE (PARTIAL SEIZURE) AND KEPPRA
COMMON SIDE EFFECTS OF CARBAMAZEPINE
SIADH
MOST COMMON HYDROCEPHALUS IN TBI
COMMUNICATING, NORMAL PRESSURE
HYPONATREMIA IN TBI
OCCURS IN THE FIRST 2 WEEKS POST TBI
SIADH: EUVOLEMIC. INAPPROPRIATE INCREASED ADH. Tx- FLUID RESTRICTION
CSW: HYPOVOLEMIC. APPROPRIATE INCREASED ADH. Tx- HYDRATION
DIABETES INSIPIDUS
HYPERNATREMIA
EUVOLEMIC
Tx-DDAVP
FAVORABLE EEG
RHYTHMIC THETA ACTIVITY. FRONTAL RHYTHMIC DELTA ACTIVITY. SPINDLE PATTERNS
POOR PROGNOSIS EEG PATTERN
LOW AMPLITUDE DELTA. BURST SUPPRESSION. ISOELECTRIC ACTIVITY.
TPA
3-4.5 WINDOW
BP LESS THAN 185/110
CONTRAINDICATIONS: MORE THAN 80 YEARS OLD, ANTICOAGULATION, NIHSS>25, MCA ISCHEMIA MORE THAN 1/3, Hx OF STROKE AND DM, SEIZURE DUE TO THE STROKE
BROCA: FLUENCY, COMPREHENSION, REPETITION, LOCATION AND TEHRAPY
NO, YES, NO, LET SUPERIOR MCA INFERIOR FRONTAL AND MELODIC INTONATION THERAPY (MIT)
WERNICKE’S: FLUENCY, COMPREHENSION, REPETITION AND LOCATION
YES, NO, NO, LEFT INFERIOR MCA POSTERIOR TEMPORAL
GERTSMAN SYNDROME
AGRAFIA, AGNOSIA, ACALCULIA
WALLENBERG
LATERAL MEDULLA, PICA, CN:IX AND X, ATAXIA, HORNER’S, SENSATION AT IPSIL FACE AND CONTRALATERAL HEMIBODY.
DON’T PICA HORSE THAT CAN’T SWALLOW
MILLARD GUBLER
PONS, BASILAR, CN: VI, VII
WEBER’S
MIDBRAIN, PCA, IPSIL CN III, CONTRALAT HEMIPARESIS
PNF
DIAGONAL MOVEMENT
BRUNSTROM
SYNERGISTIC PATTERNS
BOBATH
INHIBITS PRIMITIVE PATTERN. FROM PROXIMAL TO DISTAL.
ROOD APPROACH
SENSORIMOTOR APPROACH
GOLD STANDARD STUDY FOR DYSPHAGIA
VIDEOFLUOROSCOPY, MODIFIED BARIUM
RISK FACTORS FOR MORTALITY AFTER STROKE
BRAINSTEM INVOLVEMENT, CARDIAC DISEASE, CONSCIOUSNESS, DM, DELAYED MEDICAL CARE, HEMORRHAGIC STROKE, NURSING STROKE, STROKE SEVERITY, OLDER AGE, INCREASED BLOOD SUGAR.
RISK FACTOR FOR NOT RETURNING TO WORK
LOW BARTHEL (FUNCTIONAL ADLs) AT DISCHARGE, PROLONGED REHAB LOS, APHASIA, PRIOR ALCOHOL ABUSE
BRAIN MET
LUNG>BREAST>MELANOMA
MOST COMMON MALIGNANT TUMOR IN CHILDREN
MEDULLOBLASTOMA
MOST COMMON BENIGN TUMOR IN CHILDREN
ASTROCYTOMA
MOST COMMON MALIGNANT TUMOR IN ADULTS
GBM
