TBI Flashcards
TBI
Alteration in brain function, or other evidence of brain pathology, caused by an external force
Closed or open injury
Timeline is important for assessing TBI
Closed injury
Non-penetrating, outside force impacts head, skill is not broken
Open injury
Penetrating, results when skull is broken, fractured, or penetrated
Primary injury
What we think of as brain injury, immediate cause
A fall, car accident, etc.
Diffuse injury
Secondary injury
Occurs in the hours/days following the primary injury as the injury evolves
Intracranial pressure from hemorrhage, iatrogenic effects from the treatment, etc.
Could be focused or diffuse
Mild TBI/Concussion
70-90% of TBI’s are mild
Higher rates are found in: less than 24 year old men, greater than 74 years old, vulnerable populations, substance abusers
Clinically and pathologically distinct from moderate/severe TBI
Neurons dysfunctional, but not destroyed
Most common causes of mild TBI
Vehicle crashes, cycling accidents, assaults, sports injury
Most common outcome of mild TBI
Full cognitive recovery expected within 7-30 days
Around 3% have recoveries lasting greater than 1 month
Post-concussive syndrome
Presence of persistent subjective cognitive/emotional complaints greater than 3 months post injury
Commonly occurs with comorbid psychiatric distress
Does not correlate with injury severity variables
Can also be associated with inadequate pain symptom management
Moderate/severe TBI
Destruction and sheering of white matter (diffuse axonal injury)
Predicting recovery from moderate/severe brain injury
Force of trauma/severity of injury
Brain functions affected
Areas of brain function not affected
Patient’s age
Other injuries to body
Recovery from moderate/severe TBI
Most recovery occurs in the first year
Most rapid in first 3-6 months, plateau around 2 years
Functional recovery can continue based on rehabilitation
Age at time of injury is important
Notably worse recovery after 40
Longer length of post-traumatic confusion the older you are
