Ch 4: Mild TBI

Question 1

What percent of American TBIs are mild?

Answer 1

75%

1.1 million annually

Question 2

What percent of mild TBI’s do not seek medical care that is needed?

Answer 2

16-25%

Question 3

What is a mTBI?

Answer 3

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

Question 4

What are the parameters for meeting the diagnosis of mild traumatic brain injury?

Answer 4

• normal structural imaging
• LOC= 0-30 min
• AOC= from a moment up to 24 hr
• PTA= 0-1 day
• GCS 13-15

Question 5

What does abnormal imaging mean?

Answer 5

Moderate or severe TBI

Question 6

Which type of injury is the most common form of damage to brain structure?

Answer 6

Diffuse atonal injury

Cannot be readily seen using typical imaging methods, therefore making dx via brain scans inconclusive

Question 7

How is an mTBI diagnosed?

Answer 7

Solely by use of behavioral definitions

Question 8

Second impact syndrome

Answer 8

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

Question 9

mTBI Symptoms

Answer 9

Typically occur immediately after injury and resolve within a short amount of time (2-4 weeks)

10-15% experience symptoms past that point

Question 10

Frontal release

Answer 10

Damage to the frontal areas of the brain resulting in disinhibition and abnormal behaviors

Question 11

Disinhibition

Answer 11

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

Question 12

Fatigue

Answer 12

Typically arises 2’ 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.

Question 13

What is CTE?

Answer 13

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