neuropsychatric sequelae Flashcards
impact forces
contact with object
TBI
force acting on the brain that results in disturbance in level of consciousness (not necessarily loss of consciousness)
inertial forces
acceleration or deceleration of brain
distribution of diffuse axonal injury
subcortical white matter
corpus callosum
sequelae of DIA
axon is stretched increased permeability calcium influx damage to cytoskeleton impaired axoplasmic transport axonal swelling detachment and axonal death
primary injury
contusions
hemorrhages
DAI
secondary injury (evolves over time)
massive release of NT
cerebral edema/ischemia/hypoxia
increased intracranial pressure
subsequent traggering of excitotoxic injury cascades
parameters of assessing TBI
loss of consciousness
duration of post traumatic amnesia
glasgow coma scale score
percentage of mild TBI
70-80%
risk factors
gender- male
age- children under 4, individuals between 15-24, after 75
life tendencies
time- midafternoon, early evening, weekends, summer months
life tendencies
half of all traumatic brain injuries frm alcohol use
adhd/impulsivity
highest rates of TBI (age)
highest for people over 65
leading cause for people over 65
falls
leading cause for 5-24
motor vehicle crashes
ages 0-4
assualts
highest rates of ED visiss age
0-4 years
leading cause of TBI-ED visits/hospitalizations
falls
TDI disturbances
physical
cognitive
emotional/behavioral
neuropsychiatric disorder
about half of people who get TI
major categories of neuropsych sequeale- dysecutive syndromes
disorders of social comportment
disorders of motivation
disorders of executive cognition
psychiatric disorders
frontal subcortical circuits
dorsolateral prefrontal
lateral orbitofrontal
anterior cingulate
dorsolateral prefrontal
executive fx
lateral orbitofrontal
social intelligence
anterior cingulate
motivation
dysfunction in 1 frontal subcortical circuit
dysfunctionint hem all
most common cognitive complaint
memory (most common-working, short term, encoding)
dorsolaterla PFC
planning
set-shifting
problem solving
working memory
cognitive domains
complex attention executive function learning/memory language social cognition
pharamacologics fall under two categories
clinically studied
those showing promise in preclinical studies
clinically studied
statins
progesterone
cycosporine
statins
target excitotoxicity
apoptosis
inflammation
edema
progesterone
excitotoxicity apoptosis inflammation edema oxidative stress
SUR1-regulated NC channel inhibitors
apoptosis
edema
secondary hemorrhage
inflammation
cell cycle inhibitors
apoptosis
inflammation
PARP inhibitors
apoptosis inflammation
show promise in prelinical trials
diketopiperazines substance P antagonists SUR1-regulated NC channel inhibitors cell cycle inhibitors PARP inhibitors
guidelines for medical management
start low
go slow
stop sooner
