Long Term Consequences of TBI Flashcards
We all know that young men are idiots. But why do older men have more TBI?
They drink more. Falls -> TBI.
Leading cause of TBI overall?
Guns.
are tbi more common in men or women?
men 2:1
What are the 3 parts of the Glasgow coma scale?
Eyes, Best Motor Response, Best Verbal Response
Which of the 3 parts of the Glasgow coma scale is most important?
The Best Motor Response. Eyes can have problems, people can be intubated and not speaking.
what is leading cause of tbi-related death?
firearms
What is the “eyes” part of the Glasgow coma scale?
Do they open spontaneously or in response to verbal command, pain? Or not at all?
how common are tbi? (traumatic brain injury)
230,000 annual hospitalizations
50,000 deaths/year (30% of all trauma)
80,000 long term disability
5.3 million people - prevelence
what are three parts to GCS? And how many points does each contribute?
motor - 6
verbal - 5
eye - 4
how is score for eyes in gcs determined?
open spontaneously - 4
to verbal command - 3
to pain - 2
no response - 1
where are two peaks in tbi-related deaths for men?
late teens/early 20’s
>70 - alcohol related falls
what is glascow coma scale?
a neurological scale that aims to give a reliable, objective way of recording the conscious state of a person for initial as well as subsequent assessment
how is score for verbal determined?
oriented and converses - 5
disoriented and converses - 4
inappropriate words - 3
incomprehensible sounds - 2
no response - 1
how do total scores for gcs detemine severity?
severe < 9
moderate 9 - 12
minor 13 - 15
how is score for motor determined?
obeys verbal command - 6 to painful stimuli - localizes pain - 5 flexion withdrawal - 4 flexison abnormal - 3 extension - 2 no response - 1
how are CTs graded in severe tbi?
_ Diffuse Injury _ I: no swelling _ II: minimal swelling _ III: cisterns absent _ IV: swelling + shift _ Evacuated mass lesion _ Non-evacuated mass lesion
what is CT grading important?
good predictor of outcome
what is glascow outcome scale?
_ good recovery: 5 _ moderate disability: 4 _ severe disability: 3 _ vegetative: 2 _ death: 1
what are goals of TBI management in ER?
_ Continue/initiate resuscitation (ABC_s)
_ Prevent secondary injury by maintaining
adequate perfusion.
_ Decreased perfusion
_ Increased cerebral vascular resistance
_ Decreased oxygenation or glucose
_ Increased metabolism
_ Obtain diagnosis of type of TBI (CT scan)
what causes diffuse injury?
inertial loading
what should be done in the field for tbi?
resucitate & intubate –> want to minimize hypoxia, hypotension and anemia
what animal model is used for focal injury?
experimental lateral fluid percussion brain injury in the rat
how is diffuse axonal injury currently diagnosed?
diagnosis of exclusion
what causes focal injury?
contact loading
