Exam 3 - Traumatic brain injury Flashcards
traumatic brain injury
serious form of head injury
disruption of brain tissue dt impact to head
incidence
male 14-24yo
death occurs at 3 points
immediately after, 2 hours, 3 weeks
etiology
vehicular fall violence sport combat
pathophysiology
primary = initial impact secondary = effects
types
concussion (head moved around)
-post concussion syndrome (gets worse, decrease pupil)
contusion (brain bruising)
diffuse axonal injury (worse prognosis, not seen on imaging)
pentration
coup contracoup injury
coup = initial contracoup = secondary impact (opposite side of that which received the initial impact)
glasgow coma scale
1-15
assess LOC (objectively)
motor, verbal, eye responses
rancho cognitive levels
I-VIII
classification of glasgow coma scale
• mild 13-15
LOC 20 min, am 1-24hrs
cerebral edema/hemorrhage on imaging
some rehab, some long term neuro deficit
• severe < - 8
LOC 6hrs >, prolonged posttraumatic amnesia
intracranial, subdural hemorrhage
numerous neuro deficit, long term rehab
traits of TBI
changes and will see
orientation, memory, judgement, attention, problem solving, motivation
confusion, agitation, resistance to treatment, confabulation, emotional liability
complications
hematoma (brain bleed) -epidural (skull; always an ER) -subdural (dura, arachnoid, meninges; acute, loc, clarity) -intracerebral (brain tissue) seizure infection
diagnostic
CT (computed tomography scan)
MRI (magnetic resonance imaging)
medical management
observation
manage ICP (HOB, osmotic diuretic, sedative)
surgery (craniotomy, craniectomy, cranioplasty, Burr-hole)
intracranial pressure
manifestation
posture signs
monitoring
change in LOC, vital signs (Cushing triad) ocular sign headache vomiting decreased motor function
decorticate
decrebrate
ventriculostomy - measure pressure on ventricles
