ch. 11: traumatic brain injury Flashcards
What is a traumatic brain injury (TBI)?
an injury to the brain caused by an external force, affecting cognitive, physical, and emotional functions
How is brain injury severity classified?
- Glasgow Coma Scale (GCS)
- length of unconsciousness
- post-traumatic amnesia (PTA)
- Mississippi PTA
What is the Glasgow Coma Scale (GCS)?
A 15-point scale used to assess coma severity and consciousness level
What is PTA?
A state of confusion that occurs immediately after regaining consciousness following a TBI
What is the Mississippi PTA?
similar to PTA just stretched out over a longer period of time
What does MRS measure in TBI patients?
Peptides and neurohormones that indicate neurochemical changes due to brain trauma.
What happens to NAA, creatine, and choline levels in TBI?
NAA decreases (signaling neuro damage), creatine decreases (used up for neuroprotection), and choline increases (indicating inflammation)
What imaging methods detect TBI-related changes?
Susceptibility Weighted Imaging (SWI) for microbleeds and Diffusion Tensor Imaging (DTI) for white matter tract integrity
What are the different mechanisms of TBI?
Closed head injuries, focal injuries, diffuse injuries, and penetrating injuries.
What is the difference between coup and contrecoup injuries?
Coup is the initial impact site, while contrecoup is the opposite side where the brain rebounds.
What is a diffuse axonal injury?
A severe injury where axons are sheared due to traumatic forces, leading to widespread damage.
What are common complications of TBI?
Edema, intracranial pressure, herniation, hematoma, hemorrhage, skull fractures, and seizures.
What increases the risk of posttraumatic epilepsy?
Penetrating injuries (50% risk vs. 4-7% in non-penetrating injuries), genetic factors, and younger age.
What qualifies as an mTBI (concussion)?
Loss of consciousness <30 min, GCS 13-15 after 30 min, PTA <24 hours.
What are common symptoms of mTBI?
Headache, dizziness, nausea, concentration issues, memory loss, mood swings, and sleep disturbances.
What is PCS?
A controversial condition where symptoms persist beyond 90 days post-mTBI.
What are key acute treatments for TBI?
Assessing airway, breathing, circulation (ABC), neurological exam, imaging, and reducing intracranial pressure.
What are the stages of recovery from a TBI?
Coma → vegetative state → minimally conscious state → confused state (PTA) → recovery.
What cognitive deficits are common after TBI?
Attention, processing speed, memory encoding, problem-solving, and executive function deficits.
What mood changes are common in TBI patients?
Depression, anxiety, irritability, impulsivity, fatigue, and social norms violations.
When is neuropsychological testing performed?
Based on the patient’s state: responsiveness (minimally conscious), orientation (confused), memory (recovering), and long-term recovery (3, 6, or 12 months post-injury).
