[MND] Traumatic Brain Injury

Question 1

Traumatic Brain Injury can be defined as

Answer 1

Damage to the brain resulting from external mechanical forces, such as rapid acceleration or deceleration, impact, blast waves, or penetration by a projectile

Question 2

Criteria for clinical identification includes one or more of the following:

Answer 2

• Confusion or disorientation
• Loss of consciousness
• Post-traumatic amnesia
• Other neurological abnormalities (i.e. seizure)

Question 3

Causes

Answer 3

Motor vehicle accidents, construction and sports, countries such as the US common causes include violence

• Sporting accidents and falls are primary factors for those under 20 years of age
• Transport accidents are common cause sin the adult populations
• Falls is a common cause in older adults

Question 4

Risk factors

Answer 4

Multiple. Range from substance and alcohol abuse to motorcyclists not wearing helmets.

Increased risk with young infants; adolescent males; risk taking behaviour; and older adults (falls)

Question 5

Epidemiology

Answer 5

NZ 20,000 to 30,000 cases per year

Every day 90 New Zealanders sustain a brain injury

Question 6

Primary Injury refers to

Answer 6

The primary mechanical damage occurring at the moment of impact. Involves cortical contusions, lacerations, diffuse axonal injuries, and skull fractures

Question 7

Secondary Injury refers to

Answer 7

Secondary damage, delayed non-mechanical damage. Can involve inflammatory responses, mitochondrial dysfunction, cerebral oedema, and haematoma’s)

Question 8

Primary Injury/Damage involves 3 main mechanisms:

Answer 8

1) Direct impact on the skull
2) Penetration through the skull into the brain
3) Collision between the brain substance and the internal structure

Question 9

Risk factors for prognosis include

Answer 9

age, gender, education, personality, substance abuse, motor score on GCS, pupil reactions, hypotension, infections and surgical interventions

Question 10

Differential diagnosis

Answer 10

Stroke (i.e. intracerebral haemorrhage)

Question 11

Outcome Measures

Answer 11

Glasgow Coma Scale (and Paediatric Glasgow Coma Scale)

Functional Independence measure (FIM)

Question 12

Coordination may be affected as a result of damage to the

Answer 12

Corticospinal tracts, basal ganglia, cerebellum, and sensory pathways.

Question 13

Basal Ganglia lesions cause

Answer 13

Slowed initiation of movement and bradykinesia

Question 14

Cognitive Impairments

Both long term and short term memory may be affected as a result of direct damage to the

Answer 14

temporal lobes and thalamus (note the hippocampus is in the medial temporal lobe)

Question 15

Muscle weakness can be caused by injury to the

Answer 15

Corticospinal tracts

Question 16

Visual system may be affected at the level of the optic nerve, or at the levels where there is processing or interpretation of visual stimuli .
The chance of visual disturbances in diffuse injures is high because

Answer 16

1/3 of the brain is involved in the processing of vision. This is important as vision plays a role in the guidance of movement and the maintenance of balance