TBI Flashcards
Other names for TBI
Acquired brain injury
Craniocerebral Trauma
Two types of TBI
Open
Closed
MOI of Open TBI
Object pierces through skull and meninges, enters the brain
MOI of Closed TBI
Injury to brain without penetration of skull
Which type of TBI is more detrimental?
Closed, no where for the pressure and swelling to go
Primary Brain Injury
Initial injury to the brain that occurs at the initial impact
What is a coup lesion?
Direct lesion on the brain under point of impact
What is a contrecoup lesion?
Injury on the opposite side of the brain caused by the rebound effect of the brain after impact
Secondary Brain Injury
Damage that occurs later, as a result of initial injury
What are examples of secondary injury?
Hematoma
Hypoxia
Ischemia
Increased intracranial pressure
Post-traumatic epilepsy
Subdural Hematoma forms between what layers?
Dura and arachnoid mater
What is a subdural hematoma secondary to?
Venous rupture
Epidural Hematoma forms between what layers?
Skull and dura matter
If hematoma is suspected, what is the action?
IMMEDIATE emergency action
Focal damage
Brain damage is focal and direct at the point of injury
Is a focal damage minor?
Yes
Patient presentation from focal damage to brain?
“presents like stroke”
localized or specific deficits
Diffuse damage
Widespread damage that affects other parts of brain
Patient presentation from diffuse damage to brain?
“presentation varies”
global deficits
prolonged vegetative state
involves many body systems/structures
What happens in a diffuse axonal injury (DAI)?
Neural cells in brain are stretched to the point of tear, axons pulled away from cell body
What causes a higher risk for dementia associated with DAI?
Deposition of tau and APP proteins (plaques and tangles)
Most common causes of DAI?
Falls
MVA
Assault/Acts of Violence
Suicide attempt
Shaken Baby Syndrome
What is a hallmark sign of a DAI (cellular level)?
“Retraction ball”
Axon draws back towards cell body
Why is it bad to have high levels of calcium from TBI?
Calcium cascade leads to apoptosis (cell death!)
Complication in axonal regeneration in CNS?
More scar tissue build (glial scar formation)
Oligodendrocytes are not as fast and efficient in healing process
Lack of clearance of debris
Is axonal regeneration easier or harder in CNS vs PNS?
Harder in CNS
Easier in PNS
What are the three components to Glasgow Coma Scale?
Eye Opening
Verbal Response
Motor Response
How are mild TBI objectively diagnosed?
Acute Concussion Evaluation (ACE)
Sport Concussion Assessment Tool 5 (SCAT 5)
What is Ranchos Los Amigos used for?
To assess how much assistance the individual will need to function on a daily basis (general assessment)
Ranchos Los Amigos: Level 1
No response: Total Assistance
Ranchos Los Amigos: Level 2
General Response: Total Assistance
Ranchos Los Amigos: Level 3
Localized Response: Total Assistance
Ranchos Los Amigos: Level 4
Confused/Agitated: Max Assist
Ranchos Los Amigos: Level 5
Confused, Inappropriate Non-Agitated: Max Assist
Ranchos Los Amigos: Level 6
Confused, Appropriate: Mod Assist
Ranchos Los Amigos: Level 7
Automatic, Appropriate: Min Assist w/ Daily Living Skills
Ranchos Los Amigos: Level 8
Purposeful, Appropriate: Stand-by Assist
Ranchos Los Amigos: Level 9
Purposeful, Appropriate: Stand-by Assist on Request
Ranchos Los Amigos: Level 10
Purposeful, Appropriate: Mod Independent
