Ch 1: Brain Injury Overview Flashcards
What is the annual cost to society when individuals with brain injury do not receive proper care?
$76.5 billion
What are the three reason why individuals with brain injury are at risk for developing significant disability?
- awareness and understanding of brain injury remain fairly limited
- brain injury is frequently not identified
- treatment is not always readily available
What is an acquired brain injury?
Injury that is not hereditary, congenital, degenerative, or induced by birth trauma.
Define TBI
an alteration in brain function, or other evidence of brain pathology, caused by an external force.
What is a traumatic impact injury?
Head is struck by or against an object resulting in open or closed injury
What can happen as a result of a closed injury?
can cause brain lacerations, contusions, or intracerebral hemorrhage within the brain causing focal injuries. (coup-countercoup)
What is a diffuse axonal injury? (DAI)
Tearing or shearing of axons
What is an open injury?
breach of the skull or the meninges, often resulting in focal injuries (i.e.: epidural or subdural hematoma, or intracerebral hemorrhage)
What is a major complication of penetrating injuries?
secondary infection due to skull or meningeal breach
What are traumatic inertial injuries?
non-impact injuries resulting from inertial force (acceleration deceleration forces)
What is a coup injury
The injury to the brain when it contacts the skull during brain acceleration forward
What is countrecoup injury?
where the brain rebounds to (opposite side) of the skull after coup injury
What happens when rotational or angular forces apply to the injury?
DAI
What is a non-traumatic brain injury?
causes damage to the brain by internal factors, such as lack of O2 or nutrients to the nerve cells, exposure to toxins, pressure from a tumor/blockage, or other neurological disorders
primary injury
primary damage, mechanical damage
secondary injury
pathophysiological processes and delayed non-mechanical processes
What is the estimated annual incidence rate of TBI?
2.5 million
What is the risk for a second TBI after the first one?
3x greater
After sustaining a second TBI, how high is the risk for another injury?
8x greater
What are the 2 age groups with high rates of falls causing TBI?
0-4 and 75+
What is the greatest cause of TBI related ED visits/hospitalizations?
Falls
What is the greatest cause of TBI deaths?
Motor vehicle crashes
Rates of TBI from MVCs are highest for which age group?
Adults 20-24
Define: Concussion
Trauma-induced alteration in mental status, may or may not involve loss of consciousness, can result in memory loss for events before or after trauma, can result in local neurological deficits that may or may not be transient
What is the amount of LOC by severity level?
Mild- no or up to 30 minutes
Moderate- up to 24 hours
Severe- more than 24 hours
How many sport related concussions occur each year?
1.6 to 3.8 million
What are the age groups most likely to sustain TBI?
15-19
20-24
65+
Which age group has the highest rate of TBI related hospitalization and death?
75+
Nonaccidental trauma is the cause of at least ____% of deaths from head trauma in children under two years old?
80%
What fraction of children under three years old, who are physically abused have TBI’s?
2/3
___% of all TBI related emergency department visits involve children aged 0-4 years old
18%
Falls are the cause of ____% of the TBI’s among children age 0 to 14 years
50%
Firearm related TBI death rates were highest among which age group’s?
20 to 24 and over 75 years of age
Motor vehicle related TBI death rates were highest among which age group?
15 to 24 years of age
Fall-related TBI death rates are highest amongst which one age group?
75 years of age and older (increase significantly with age)
The risk of TBI related death in motor vehicle crashes is highest among which age group?
16-19 years old
30% result in TBI
How many prisoners have Brain injuries that are not necessarily recognized, diagnosed, or treated?
2 million
What percent of soldiers have a TBI?
10-20%
Alcohol is involved in what percent of TBI’s?
37 to 51%
What percent of women victims of domestic violence add symptoms associated with brain injury?
67%
Including 30% with loss of consciousness after a blow to the head and 60% with no loss of consciousness yet having positive symptoms
What are 5 screening tools used to identify brain injury?
Acute Concussion Evaluation (ACE) brief and general
HELPS tool (brief and general)
ImPACT (more lengthy and comprehensive) frequently used with athletes suspected of having a concussion
Warrior Administered Retrospective Casualty Assessment Tool (WARCAT) used in military
Trumatic Brain Injury Questionnaire (TBIQ). a brief interview based instrument develop to assess the history of head injury among offenders involved in the criminal justice system
TBI is a contributing factor to what fraction of all injury related deaths?
1/3
What was the outcome of the Olmstead decision?
Federal and state initiatives that allow for persons with disabilities to live in the community
What was the importance of the TBI Act of 1996?
Acknowledged the incidence and prevalence of TBI and set funding for research to improve quality of services
What funds federal dollars to states to improve the integration of services for TBI?
TBI State Grant Program administered by HRSA- Health Resources and Services Administration
How is mortality impacted by TBI?
Twice as likely to die as non-brain injured persons and have reduction of 7 years in life expectancy
