Cog General Info Flashcards
Acceleration/Deceleration Injiry
- car hits something
- you hit soemthing in car (coup)
- brain hits the skull (contrecoup) ??`
most vulnerable areas to brain injury
- orbitofrontal
- anterior temporal horns
- brainstem
Rational Injury (DAI)
- diffuse axonal injury
- shearing forces
- doesnt show up on MRI so pts are deemed “fine”
- theres metabolic damage to the neurons which causes cog difficulties
anoxia
- lack of oxygen to the brain
- can occur if ICP>BP
Immediate TBI consequences
laceration, contusion, DAI, coma, hypoxia, subdural/subarachnoid hemorrhage, CN damage
cerebral contusion to orbitofrontal
lots of movement
cerebral contusion to dorsolateral
pseudo-depressed syndrome, lack of niiation and motivation
cerebral contusion to anterior temporal lobe
- attentional and memory problems
- disorganized thoughts, confusional states
cerebral ocntusion to base of forebrain
(thalamus/hypothalamus damage)
-attention, memory, emotional control problems
specific lobe injiry
-deficits relating to lobe
DAI
severity of coma relates to degree of DAI
immediate consequences of corpus collosum damage
-distractibility, decreased attention
immediate consequences of midbrain damage
-sucebtible to coma
immediate consequences of cerebellar damage
-ataxia
Intermidiate consequences
- deemed the “gray” hours/days/weeks after TBI
- subdural hematoma, herniation of brain matter, cerebral edema, hydrocephalus, siezure
subdural hematoma intermediate conequences
- may be a gradual leaking of blood
- results in anoxia if ICP>BP
intermediate cons: herniation
- herniation of brain matter through tentorium
- affects the brainstem
- could turn into PCA stroke
intermediate conseq: cerebral edema
-brain tissue sweeling, could cause necrosis
intermed conseq: hydrocephalus
- CSF trapped in ventricles
- causes high ICP, could also cause necrosis
Late consequences of TBI (months/years lateR)
- chronic subdural hematoma
- hydrocephalus
- depression
late conseq: chronic subdural hematoma
- recurring head ache
- subtle hemiparesis
- regression in function
- variation in arousal
- may need a shunt
late cons: hydrocephalus
-shunt obstruction could cause changes in function, gate, behavior, or dementia
drepression (late conseq)
- organic: changes in chemical balance
- reactive: response to all the things that have happened
Prognostic indicators frolllwing TBI
- duration of coma
- duration of ICP
- areas of brain contusion
- location of lobe (frontal lobe=poorer outcome)
- time until med attention received
- length of time PTA (PTA over a day is not good)
- intelligence and drug use pre-injury
- family involvement
- financial resources
