Ch 4: Mild TBI Flashcards
What percent of American TBIs are mild?
75%
1.1 million annually
What percent of mild TBI’s do not seek medical care that is needed?
16-25%
What is a mTBI?
Traumatically induced physiologic disruption of brain function, as manifested by at least one of the following:
- any period of loss of consciousness
- any loss of memory for events immediately before or after the incident
- any alteration in mental state at time of injury
- focal neurologic deficits that may or may not be transient
- negative CT or MRI
What are the parameters for meeting the diagnosis of mild traumatic brain injury?
- normal structural imaging
- LOC= 0-30 min
- AOC= from a moment up to 24 hr
- PTA= 0-1 day
- GCS 13-15
What severity of TBI would have abnormal imaging?
Moderate or severe TBI
Which type of injury within the brain is the most common form of damage to brain structure?
Diffuse axonal injury
Cannot be readily seen using typical imaging methods, therefore making dx via brain scans inconclusive
Second impact syndrome
A rare but potentially fatal condition.
Athletes under the age of 24 are at the greatest risk for second impact syndrome if they return to play while still neurologically at risk
mTBI Symptoms- how quickly do they resolve and what percent of the time do symptoms persist?
Typically occur immediately after injury and resolve within a short amount of time (2-4 weeks)
10-15% experience symptoms past that point
Frontal release
Damage to the frontal areas of the brain resulting in disinhibition and abnormal behaviors
What is disinhibition and what other symptoms are typically present with it?
Engaging in behaviors on impulse without reflecting on potential future consequences
Typically present with increased liability, social inappropriateness, or by physically acting out.
Depression and apathy are also common
What is the cause of fatigue post mTBI? What makes it worse?
Typically arises because of mental overexertion vs physical overexertion, especially when significant concentration or high-level thinking is required.
Fatigue is worsened by the injury’s effect on sleep patterns, causing more fatigue and worsens memory and behaviors.
What is CTE?
Chronic traumatic encephalopathy
A rare, progressive, degenerative condition of the CNS, seen in repetitive brain trauma
Tau proteins release after DAI and are changed structurally by metabolic breakdown of brain cells following trauma, and create a chronic inflammatory state
ALS and seizures in temporal lobe d/t scarring
What neurotransmitter is massively released following mTBI and what is the effect?
Glutamate; affects the balance of sodium and potassium which keeps nerve cells from working properly
Vision changes post mTBI
blurred vision, convergence insufficiency- eyes cannot focus effectively together
What is the most common complaint after mTBI?
Headaches, worsen with physical and mental exertion
