Cognitive and Psychological Consequences of Brain Injury Flashcards
What is acquired brain injury?
Umbrella term
Injury to brain after birth
What are some types of acquired brain injury?
Stroke Infections Traumatic brain injury Hypoxic injuries because of myocardial infarcts Neurodegenerative
Which areas of the brain are most sensitive to hypoxic injury?
Hippocampus
Areas of shared vascular territories
What are some types of congenital brain injury?
Encephalopathy
Some epilepsies
Developmental defects
What are some factors that contribute to having a congenital brain injury?
Genetic factors Environmental factors - Vitamin deficiencies - Foetal alcohol syndrome - Prenatal infection
What are traumatic brain injuries?
Sudden trauma causing injury to brain
What are some examples of neurodegenerative injuries?
Parkinson's disease Alzheimer's disease Dementia Alcohol syndrome Motor neuron disease
How do you classify a mild traumatic brain injury?
Glasgow coma scale at scene: 13-15
Time of unconsciousness:
How do you classify a moderate traumatic brain injury?
Glasgow coma scale at scene: 9-12
Time of unconsciousness: 30 min-6 hrs
Length of post-traumatic amnesia: 1-7 days
How do you classify a severe traumatic brain injury?
Glasgow coma scale at scene: 3-8
Time of unconsciousness: >6 hrs
Length of post-traumatic amnesia: >7 days
What is the most important factor in classifying traumatic brain injury?
Length of post-traumatic amnesia
What is the biggest cause of traumatic brain injury?
Car accidents
What are some causes of traumatic brain injury?
Car accidents Falls Fights Blast injuries Domestic violence Child abuse
What are the risk factors of having a traumatic brain injury?
Male (2:1) - until elderly when it evens out Substance use - Especially alcohol Age - 0-4 yrs - 15-24 yrs - Over 75 yrs Psychosocial factors - Risk taking behaviour - History of psychiatric disorder - Limited educational attainment - Unstable work history
What are predictors of a good outcome after a traumatic brain injury?
Normal function beforehand Length of post-traumatic amnesia Number of previous traumatic brain injuries Age Location Function Motivation Pre-morbid psychiatric history Cognitive reserve - Higher education - Higher intelligence
What is congenital brain injury?
Present at birth because of developmental defects/damage
What is neurodegenerative injury?
Because of ongoing neurodegenerative disease
What is post-traumatic amnesia?
Period of dense confusion after traumatic event
What can acceleration and deceleration forces cause to the head?
Laceration of scalp
Skull fracture
Shifting of intracranial contents
Focal and diffuse changes in brain matter
What are some focal changes that can occur?
Haematoma
Contusion
- Commonly at basal/polar areas of frontal and temporal lobes
What are some diffuse changes that can occur?
Axonal injury
Microvascular damage
Widespread neural excitation
Metabolic changes
What are some secondary complications that can occur?
Brain swelling
Infection
Raised intracranial pressure
Respiratory arrest
Which areas of the brain are frequently damaged, and why?
Because of proximity to bony structures in skull - Frontal and temporal lobes Because of vulnerability of white matter tearing - Corpus callosum - Basal ganglia - Hypothalamus - Superior cerebellar peduncles - Fornices Because of hypoxia - Hippocampus
What are the common and prominent cognitive and psychological difficulties associated with traumatic brain injury?
Processing speed Attention Working memory Executive functioning Regulating emotions Managing frustration
How long do post-concussion symptoms take to subside in mild traumatic brain injury?
Days-weeks
What are common physical symptoms after a mild traumatic brain injury?
Headache Dizziness Fatigue Blurred/double vision Sensitivity to noise and/or bright lights Tinnitus
What are common psychological symptoms after a mild traumatic brain injury?
Restlessness Insomnia Irritability Anxiety Depression
What are common cognitive symptoms after a mild traumatic brain injury?
Reduced
- Processing speed
- Attention
- Memory
What is persistent post-concussive syndrome?
Symptoms persisting after mild TBI and can result in ongoing disability and adjustment difficulties
What is persistent post-concussive syndrome associated with?
Pre-injury physical and psychiatric problems Adjustment issues Coping style Presence of additional stressors Previous TBIs
What are the physical symptoms after a moderate to severe traumatic brain injury?
Fatigue
Balance and coordination difficulties
More specific effects dependent on specific location and severity of injury
What are the cognitive symptoms after a moderate to severe traumatic brain injury?
Attention Information processing speed New learning and memory Word-finding problems Executive difficulties - Planning - Problem solving - Goal directed behaviour - Abstract thinking - Mental flexibility Impulsivity Emotional regulation difficulties Reduced insight
What are the psychological and behavioural symptoms after a moderate to severe traumatic brain injury?
Increased irritability Aggression Lowered frustration tolerance Reduced initiative/apathy Flattened affect Verbosity Egocentricity Mood swings Excessive emotion Reduced emotion perception Reduced behavioural insight
