Ch 15: What is traumatic brain injury

Question 1

Traumatic brain injury (TBI)

Answer 1

• mechanical force
• (temporary) loss of consciousness after impact
• major symptom: loss of memory

Question 2

Post-traumatic amnesia (PTA)

Answer 2

• disturbed encoding
• disorientation
• loss of memory that occurs in the chronic phase

Question 3

TBI: primary damage

Answer 3

open injury: focally located
closed injury: diffuse (white matter)
linear force: damage grey matter (contusions)

Question 4

coup-contrecoup

Answer 4

location of cortical damage is diagonally opposite the location of the injury

Question 5

TBI: secondary damage

Answer 5

caused by complications:

• intracranial: swelling, bleeding
• extra cranial: disrupts autoregulation –> shock/hypotension/hypoglycaemia –> insufficient oxygen (hypoxia)

Traumatic subarachnoid haemorrhage –> poorer and slower cognitive recovery

intracranial pressure –> secondary diffusive brain damage

Question 6

TBI: diagnosis

Answer 6

from coma to PTA (unable to store new info for a certain period)
duration PTA strongest indicator of the severity of the injury and a useful predictor of recovery

Question 7

TBI: neuropsychological consequences (moderate to severe injury)

Answer 7

• speed of info processing
• attention and concentration (focus when distracted, divided attention, sustain attention)
• executive functions
• memory

(language sometimes, social cognition)

Question 8

TBI: neuropsychological consequences (mild injury)

Answer 8

consequences usually disappear within 3 months 
main complaints: 
- memory
- attention
- speed of info processing

Question 9

post-concussion syndrome/post-concussion disorder

Answer 9

symptoms persist after mild TBI
explained via biopsychosocial model
- duration of PTA (post-traumatic amnesia) cannot predict these chronic symtoms
- psychological factors (such as stress) are predictive

Question 10

Cogniform disorder

Answer 10

patients who report unlikely severe cognitive consequences due to their mild TBI
maybe preoccupied with the possible serious consequences
not necessarily conscious

conscious or simulation? ==> malingering

Question 11

Whiplash

Answer 11

hit from behind in a car accident
extension + flexion
no brain injury –> no unconsciousness –> injury to the neck
similar symptoms to mild TBI
80% recovers in 6 weeks
persisting symptoms –> post-whiplash syndrome –> often accompanied by mood disorders, visual disorders, concentration problems