NP: Chapter 15 Traumatic Brain Injury Flashcards
what is the most common type of acquired brain injury among ppl under 50 years
traumatic brain injury
traumatic meaning…
injury is caused by violence/mechanical force that affects the skull from the outside
TBI can result in …. disorders
sensi-motor
neuropsychological
retrograde amnesia =
time before the accident, dus oude herinneringen
anterograde amnesia
after the accident, not being able to make new memories
hoeveel mensen met TBI hospitalized in europe each year
1.6 mil
how many people die from TBI
66.000
in NL hoeveel mensen per jaar
85000 (maar underestimation)
welke groep krijgt de meeste TBI
between 15-24 years old
gender bij TBI?
mannen 2x zo vaak
2 mechanisms of pathology bij TBI
- primary damage, caused by biomechanical forces that affect the skull and brain
- secondary damage caused by complications
primary damage 2 vormen
open: objects of bone fragments penetrate the meninges
closed: veel vaker, more diffuse damage (white matter injuries, contusions (grey matter damage due to linear impact zoals hoofd stoten))
secondary damage is…
door complications -> autoregulating is failing -> insufficient oxygen -> necrosis (hypoxia)
TBI ALWAYS results in …
impairments in consciousness! of het nou coma of een lichte clouding is.
wat is de transition point voor mild vs moderate-severe brain injury
als de unconsciousness for at least 15 min, and if the post-traumatic amneasia lasts 60 minutes or longer.
wat zijn de gradaties bij post traumatic amnesia
5 min = very mild
6-60 min = mild
1-24 hours = moderate
1-7 days = severe
1-4 weeks = very severe
> 4 weeks = extremely severe
3 aspects of glasgow coma scale
eye opening response
verbal response
motor response
(hoe meer punten, hoe milder de brain injury is.)
what is the most documented symptom of TBI
mental slowness, mental fatigue (speed of info processing)
7 symptoms of TBI
speed of information processing slow
attention (related to mental slowness)
executive functions
memory
language and speech
social cognition
coping and emotional complaints
typical attention problems
focusing attention when distracted
dividing attention
sustaining atttention during long tasks
executive functions complaints
less structure applying
require help to finish a task
memory complaints
may be chronic, dus even after recovery of other cognitive functions. all aspects of memory can get affected
language complaints
- aphasia, komt niet super vaak voor, alleen bij damage left hemisphere
- dysarthria: slowed speech, komt vaker voor
social cognition
meer self centered, emotionally flat, less pov of others, disinhibited behaviour, understanding others!
coping and emotional reactions
decreased mental capacity to deal with workload
emotional stability
decreased tolerance of stimuli
irritability
fatigue
headaches
dizziness
anger
fear
PTSD
depression
worries about life and the future
hoeveel tbi is mild brain injury
80%
what is it called if symptoms last for longer than 3 months
post-concussion syndrome/disorder
which factors are predictive of rapid recovery
psychological factors such as coping, stress, premorbid personality traits and mood problems
variables related to the injury are not predictive!
cogniform disorder =
patients with excessive cognitive complaints and unexpected poor cognitive performance, patient role.
= probably to avoid stress factors that have no relationship with the injury
dus hoe heten patienten die ‘overdrijven’
cogniform disorder
whiplash =
sudden swinging movement of the head backward (extension) and then forward (flexion)
als het complaints geeft: whiplash-related disorder
meeste mensen genezen van whiplash binnen…
6 weken
in hoeveel mensen blijven de symptomen van whiplash
20%
wat voor klachten heeft de groep die symtoms blijft houden
visual disorders, dizzyness, muscle weakness
wat is het verschil tussen post whiplash en post concussion
mensen die whiplash hebben gehad hebben veel pijn
