Neuro TBI Flashcards
Primary brain damage
-Usually irreversible brain damage
Diffuse axonal damage( high mortality rate)
Lacerations
Contusions
Traumatic brain injury
Physical injury to the brain
Non degenerative
Non congenital
Results in temporary or permanent neurological dysfunction which can result in cognitive physical and psychological impairments.
Coup contrecoup
Coup injury on the site of impact
Counter coup injury in the opposite site of impact
Mixed both direct and indirect injury.
Secondary brain damage
Occurs later on
Haemorrhage-extradural or subdural
Brain swelling
Infection
Diffuse axonal damage
Excessive lesions in the white matter in wide spread areas in the brain. It has a high mortality rate
Mechanisms of brain damage
Extracranial mechanisms - hypotension -hypoxia Intercranial mechanisms Primary and secondary brain damage
TBI effects can be classified into 3 categories
Physical
Cognitive
Behavioural
TBI effects: physical
Seizures,loss of motor speed and coordination.
Abnormal movements such as tremors ridgity and spasticity
Sensory problems and communication deficits
Loss of counsciousness in early or accrue stages are common
TBI effects: cognitive
Disorders of attention concentration and memory
Problems understanding or producing speech
Difficulty initiating and planning daily activities
Poor reasoning or judgement
TBI effects: behavioural
Agitation and irritability, verbal and physical aggressiveness
Impulsivity depression suicidal thoughts
An egocentric or self orientated in interpersonal relationships
Acutebstage following TBI
Loss of consciousness is quite common
GCS is used to monitor level of consciousness
Describe the Glasgow Coma Scale
It is an OM to use to asses a pt that is in acute stage following a TBI. It is used to asses the patients level of consciousness. Pt is classified by their eye opening ability, best motor response and best verbal response
Point out of 15 is given the higher the point the more conscious the patient.
Decerebrate posturing shows involvement of what part of the brain?
Brain stem
Decorticating posturing shows involvement of what part of the brain?
Thalamus, cerebral cortex, midbrain
When do you know a person is no longer in a coma?
Combines GCS of 9 or more
How does the severity of GCS work
Mild- GCS 13-15 <20 min coma duration
Moderate- GCS 9-12 <6h of coma duration
Severe- GCS <8, > 6 h of coma duration
How does recovery from a coma present?
Periods of eye opening
Utterance of words
Uninhibited noisy behaviour
Aggression
Frontal lobe lesions cause
Paralysis,head and eye movement to opp.side Hemi/monoplegia Inappropriate behaviour Loss of inhibition Loss of initiative( disinterest and unconcerned) Primitive reflexes Frontal ataxia Urinary incontenance
Parietal lobe lesion cause
Contra lateral loss of coritical sensation
Inability to appreciate size shape and weight
Receptive dysphasia
Dysphasia
Condition where there is a deficiency in generation of speech
Dysphasia means partial loss of language
Aphasia full loss of language
Acute stage following TBI what are the primary impairments of the musculoskeletal integrity
Primary impairments
Ms weakness ataxia reduced sensation.
Paralysis apraxia tremor
Spasticity or combinations of above.
Apraxia
Poor ability to plan movement execution.
Dominant parietal lobe affected by TBI
Finger agnosia
L/R confusion
Acalculia
Agraphia
Agraphia
Inability to write
