Overview and Etiology

Question 1

includes brain injuries caused by external physical forces to the head and internal insults to the brain. If caused by external force, classified as ____

Answer 1

acquired brain injury

traumatic brain injury - caused by external force

Question 2

hypoxia/anoxia, infections (encephalitis, meningitis), strokes, tumors, and toxic exposure can cause ____

Answer 2

non-traumatic acquired brain injury

Question 3

penetrating injury or gunshot are examples of causes of ____ TBI

falls, MVC crashes, assaults, explosions, and concussions are examples of causes of ____ TBI

Answer 3

gunshot - open TBI

concussion - closed TBI

Question 4

shaken baby syndrome is example of ____ acquired brain injury
lightning strike is example of ____ acquired brain injury

Answer 4

shaking baby syndrome = TBI

lightening = non-traumatic acquired brain injury

Question 5

coup/ countercoup can cause what kind of brain injury?

Answer 5

basically means whiplash. can cause closed (non-penetrating) TBI

Question 6

following primary injury is secondary injury, which can be divided into two phases. Give an example of things that could happen in each phase

Answer 6

phase 1 (macroscopic): impaired blood flow, metabolic imbalance, tissue damage

phase 2 (microscopic): intracellular breakdown, apoptosis or necrosis, free radical generation

Question 7

compare the 3 degrees of brain injury severity in LOC time and symptoms

Answer 7

mild TBI (LOC 0-30 mins): vomiting, lethargy, dizzy. Often misdiagnosed, not always evident on brain imaging. Traumatically induced physiological disruption of brain function and alteration in mental state

moderate TBI (LOC up to 24h): skull fractures with contusions/ bleeding, focal findings on EEG or CT

severe TBI (LOC 24h+)

Question 8

risk of 2nd brain injury after first (ex, concussion) is ____ x greater

Answer 8

3x greater risk of brain injury after initial injury

risk of 3rd injury is 8x greater after 2nd injury

Question 9

most TBIs that occur each year are of ____ severity and result in (hospitalization/ ER visit/ death)

Answer 9

most TBIs each year are mild and result in ER visit

but TBIs are a contributing factor to 1/3 injury-related deaths in US

Question 10

T/F: TBIs are the 2nd most prevalent disability in the US

Answer 10

TRUE (~13.5 million, 4.5%)

overall TBI rates gradually increasing but rates of death related to TBI decreasing

Question 11

what age group is at highest risk of TBI-related hospitalization and death?

Answer 11

75+ (falls and firearms)

Question 12

80% of deaths from head trauma in children under 2 are due to

Answer 12

non-accidental trauma

2/3 of children under 3 who are physically abused have TBIs

Question 13

CARF

Answer 13

Commission for the Accreditation of Rehabilitation Facilities - for post-acute brain injury programs (residential, outpatient, vocational, etc)

Question 14

JCAHO

Answer 14

Joint Commission on the Accreditation of Healthcare Organizations - for most hospital-based brain injury programs (which may also have CARF accreditation)

Question 15

who does Medicaid vs Medicare insure?

Answer 15

Medicaid: low-income
Medicare: elderly and disabled

Question 16

purpose of TBI Act of 1996 and 3 organizations involved in the cause

Answer 16

conduct research (NIH), improve services (HRSA), prevent TBI incidence (CDC)

Question 17

Olmstead Decision of 1999

Answer 17

no segregation or discrimination towards individuals with brain injuries, equal opportunity

Question 18

TBIMS

Answer 18

TBI Model Systems of Care - established 1987 by National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR)

conducts longitudinal research of course of recovery and outcomes following TBI

Question 19

Home and Community-Based Waiver Program (HCBS)

Answer 19

allows states to try new approaches to deliver healthcare as long as under a certain cost, such as case management, home aid, adult day health, other services that avoid institutionalization

Question 20

T/F TBI is a chronic disease

Answer 20

TRUE

Question 21

individuals with TBI are at increased risk of death due to all the following conditions EXCEPT (as compared to those without TBI):
aspiration pneumonia
anaphylactic reaction
seizure
septicemia
circulatory problems

Answer 21

those with TBI at higher risk of death due to aspiration pneumonia, seizure, septicemia, circulatory problems

Question 22

T/F: Alzheimer’s is associated with TBI

Answer 22

TRUE

Question 23

a brain injury with a GCS score of 10 would be classified as ____, while a score of 4 would indicate ____

Answer 23

severe TBI: GCS 3-8
moderate TBI: GCS 9-12
mild TBI: GCS 13-15

Question 24

release of this neurotransmitter can cause brain toxicity that might be seen with a mTBI (mild). What is?

Answer 24

glutamate

Question 25

damage this ___ lobe can result in disinhibition and behavior changes

Answer 25

frontal

Question 26

immediately after a TBI, this symptom signals need for medical attention

Answer 26

rapidly progressing severe headache

Question 27

PCS vs PPCS and what do they mean?

Answer 27

PCS = post-concussion syndrome
PPCS = persistent post-concussive symptoms

refer to persistence of symptoms weeks-months after mTBI. symptoms are non-specific

Question 28

CTE

Answer 28

chronic traumatic encephalopathy - rare complication, progressive degenerative condition

diffuse axonal injury –> tau protein release –> inflammation