TBI Flashcards
injury that occurs at the time of trauma
TBI primary injury
what is the pathogenesis of TBI primary injuries?
diffuse axonal injury d/t coup and counter-coup
injury that is initiated at the time of initial trauma and continues for hours or days
TBI secondary injury
what does TBI secondary injury lead to? (3)
neuron death
cerebral edema
increase ICP
what kind of injuries will result in greater axonal damage? (2)
assault
falling object
unable to remember things that happened after the injury
anterograde amnesia
unable to remember what happened right before the injury
retrograde amnesia
a patient opens their eyes when spoken to, can have a conversation but is disoriented, and makes withdrawal movements to pain. what is their GCS?
11
a patient opens their eyes when you walk in the room, grunts, and follows motor commands. what is their GCS?
12
a patient only opens their eyes when you pinch their skin, says inappropriate words, and uses extensor posturing to pain. what is their GCS?
7
what is the classification of TBI if GCS is 13-15?
mild
what is the classification of TBI if LOC is over 30 mins and GCS is 9-12?
moderate
what is the classification of TBI if LOC is over 24 hours and GCS is 3-8?
severe
in which patients is hospital admission recommended? (4)
GCS < 15
abnormal CT
seizures
underlying coagulopathy
what is the management for moderate/severe TBIs? (3)
monitor for ischemia, cerebral edema, increased ICP
monitor for coagulopathy (PT/INR)
monitor for seizures (EEG)
what can we give for increased ICP in moderate/severe TBI? (2)
mannitol
normal saline
elevate head of bed
what should be avoided in patients with moderate/severe TBI?
glucocorticoids
what is the hallmark of concussions/mild TBIs? (3)
confusion
amnesia
+/- loss of consciousness
according to the AAN, what is classified as a grade 3 or severe concussion/mild TBI?
loss of consciousness
according to the AAN, what is classified as a grade 2 or moderate concussion/mild TBI?
symptoms that last over 15 mins
when is a recurrent concussion more likely to occur?
within 10 days after a prior concussion
what is not necessary in sports-related concussions to be diagnosed?
CT imaging
what is the management for mild TBI/concussion? (3)
cognitive and physical rest
NSAIDs for pain
follow up
what is the return to play precaution for a concussion?
patient must be asymptomatic without medication
