Concussions/Mild Brain Injury

Question 1

What is a TBI

Answer 1

disruption of brain fucnction caused by blow or jolt to head or penetrating head injury

Question 2

What 5 things are partt of the definition of TBI

Answer 2

• any period of loss or decreased level of consciousness
• any loss of memory for events immediately before or after injury
• any alteration in mental state at the time of injury
• nuerlogical deficits that may or may not be transient
• intracranial abnormalities (DAI, contusion)

Question 3

What the effects on mTBI on brain

Answer 3

affects electrical and/or chemical functioning of the brain.

Question 4

What percent of ER visits are for mTBI

Answer 4

70-85%.

Question 5

What is the GCS, loss of consciousness, and Post traumatic amnesia

Answer 5

GCS=13=15
LOC= <30 minutes. OFten there’s no loss of concsiousness
PTA< 24 hours. Oftentimes no PTA, or very brief disorientation.

Question 6

What mental states or nuerological deficits are characteristic of mTBI

Answer 6

Includes any alteration in mental state or focal neurological deficit even if it’s transient.

Question 7

What are some signs and symptoms of mTBI

Answer 7

headache, nausea, Cognitive changes, Emotional behavioral changes, sensory changes, sleep disturbances

Question 8

What are sensory changes associated with mtbi?

Answer 8

dizziness/vertigo
sensitivity to light/sound
tinnitus
blurred vision

Question 9

What are the cognitive changes related to MTBI

Answer 9

Confustion/disorientation (PTA)
slowed processing time and reaction time
memory difficulties
difficulty concentrating
difficulty with planning, sequencing, follow-throuhg
cognitive fatigue
* may be more vulnerable under adverse conditions

Question 10

What are the Emotional/Behavioral changes

Answer 10

irritability
decreased emptional control/lability
depression
anxiety
lethargy

Question 11

What is the recovery like for mTBI

Answer 11

resolve by 3-6 montsh in 70%
resolve by 12 mos for 85%
8-15% continue to report symptoms 1+years after injury

Question 12

How do persistent symptoms relate to subsequent injuries

Answer 12

Persistent symptoms may increase after subsequent injuries.

Question 13

What are the two types of persistent symtpoms

Answer 13

Physiogenic and psychogenic. There is interaction between the two.

Question 14

What are physiogenic symptoms

Answer 14

physical changes to the brain such as Nuerotransmitter dsysfucntion, axonal shearing,

• evidence of structural damange in MRI
• PET scan studies: decreased metabolism in medial temporal, and posterior frontal regions
• nueronal changes identified postmortem

Question 15

What is post concussion syndrome?

Answer 15

cognitive, emotional, behavioral, symptoms of concussion

Question 16

What is Psychogenic

Answer 16

-

• correlations between post-concussive symptoms and stress
• little correlation between magnitude of complaint and objective assessment
• Litigation may play a role

Question 17

What is early intervation in concussion

Answer 17

Education of employers, teachers, patients family.

• talk about symptoms
• emotional responses
• tratment and strategy training for underlying cognitive difficulties

Question 18

What is the connection between education and outcomes

Answer 18

individuals with mTBI who are educated about concussion have better long-term outcomes that those who don’t get any education

Question 19

What are important elements to include in education

Answer 19

Normalization of early cognitive, physical, emotional, behavioral symptoms.
Lifestyle and enviornmental eadaptations to facilitae recovery
Education about signs of stress and how to reduce stress

Question 20

How can we prevent concussions

Answer 20

seat belts, helments, proper technique/equipment for sports

Baseline testing for athletes

Question 21

What is orientation

Answer 21

awareness of person, place time, circumstance, post-traumatic amnesia,

Question 22

What brain structures are important for attention/concentration

Answer 22

Brainstem (RAS) and thalamofrontal systems are critical to these processes and susceptible to damage in TBI

Question 23

What are the cognitive sequelae of TBI

Answer 23

orientation, attention/concentration, memory problems, exective functions, communication, anasognosia, behavioral disorders

Question 24

What are the Memory problems seen in mTBI

Answer 24

can affect, encoding, storage, consolidation of memories.

Question 25

What are exective function deficits seen in mTBI

Answer 25

planning, judgement, decision making. Reliant on prefrontal cortex.

Question 26

What is affect of mTBI on communication

Answer 26

Any aspect can be disrupted by TBI because communication is reliant on memory, attention, memory, executive functions
-disorganized discourse, inappropriate social interactions, problems with abstract language

Question 27

What are some behavioral disorders seen in tBI

Answer 27

disinhibition, irritability, aggression, sexual acting out, rigidity, egocentrism, impaired social perception,