Concussions/Mild Brain Injury Flashcards
What is a TBI
disruption of brain fucnction caused by blow or jolt to head or penetrating head injury
What 5 things are partt of the definition of TBI
- 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)
What the effects on mTBI on brain
affects electrical and/or chemical functioning of the brain.
What percent of ER visits are for mTBI
70-85%.
What is the GCS, loss of consciousness, and Post traumatic amnesia
GCS=13=15
LOC= <30 minutes. OFten there’s no loss of concsiousness
PTA< 24 hours. Oftentimes no PTA, or very brief disorientation.
What mental states or nuerological deficits are characteristic of mTBI
Includes any alteration in mental state or focal neurological deficit even if it’s transient.
What are some signs and symptoms of mTBI
headache, nausea, Cognitive changes, Emotional behavioral changes, sensory changes, sleep disturbances
What are sensory changes associated with mtbi?
dizziness/vertigo
sensitivity to light/sound
tinnitus
blurred vision
What are the cognitive changes related to MTBI
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
What are the Emotional/Behavioral changes
irritability decreased emptional control/lability depression anxiety lethargy
What is the recovery like for mTBI
resolve by 3-6 montsh in 70%
resolve by 12 mos for 85%
8-15% continue to report symptoms 1+years after injury
How do persistent symptoms relate to subsequent injuries
Persistent symptoms may increase after subsequent injuries.
What are the two types of persistent symtpoms
Physiogenic and psychogenic. There is interaction between the two.
What are physiogenic symptoms
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
What is post concussion syndrome?
cognitive, emotional, behavioral, symptoms of concussion
What is Psychogenic
-
- correlations between post-concussive symptoms and stress
- little correlation between magnitude of complaint and objective assessment
- Litigation may play a role
What is early intervation in concussion
Education of employers, teachers, patients family.
- talk about symptoms
- emotional responses
- tratment and strategy training for underlying cognitive difficulties
What is the connection between education and outcomes
individuals with mTBI who are educated about concussion have better long-term outcomes that those who don’t get any education
What are important elements to include in education
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
How can we prevent concussions
seat belts, helments, proper technique/equipment for sports
Baseline testing for athletes
What is orientation
awareness of person, place time, circumstance, post-traumatic amnesia,
What brain structures are important for attention/concentration
Brainstem (RAS) and thalamofrontal systems are critical to these processes and susceptible to damage in TBI
What are the cognitive sequelae of TBI
orientation, attention/concentration, memory problems, exective functions, communication, anasognosia, behavioral disorders
What are the Memory problems seen in mTBI
can affect, encoding, storage, consolidation of memories.
What are exective function deficits seen in mTBI
planning, judgement, decision making. Reliant on prefrontal cortex.
What is affect of mTBI on communication
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
What are some behavioral disorders seen in tBI
disinhibition, irritability, aggression, sexual acting out, rigidity, egocentrism, impaired social perception,
