TBI

Question 1

Incidence of TBI in western countries

Answer 1

250-300 per 100,000; 1.5 million per year in US

Question 2

gender/ age info TBI

Answer 2

3x more in men, 15-24

Question 3

most common causes TBI

Answer 3

MVA (some estimates more than 50% adolescent injuries)

children: sporting events, child abuse, falls
elderly: falls

Question 4

Affects aging on TBI outcomes

Answer 4

higher mortality rates, more cognitive impact, longer rehab stays, poorer outcomes, pre-existing health issues may contribute

Question 5

Prognostic indicators TBI (11)

Answer 5

age, gender, presence prior brain injury, severity, length of coma, hypoxia, hypotension, initial GCS, etiology, rehab length of stay, duration of post-traumatic amnesia (PTA), timing of rehab, intensity of rehab

Question 6

Long Term Outcomes TBI

Answer 6

moderate to severe injury do better than severe. can expect independent living for moderate. not necessary productive activity/ work

Question 7

Criteria for minimally conscious state (5)

Answer 7

Signs of any skill, may be inconsistent. 1) Comprehend simple command 2)manipulate object 3) answer/gesture yes/no 4) intelligible speech 5) emotional or movement not reflexive

Question 8

Sign emergence from minimally conscious state.

Answer 8

Reliable and consistent evidence communication or use of object. Must rule out aphasia and apraxia.

Question 9

Vegetative state no evidence of… (4)

Answer 9

VS. No evidence of: 1) follow command. 2) intelligible verbal response. 3) verbal/gestural attempt to communicate. 4) localizing or automatic motor response.

Question 10

Is length minimally conscious state prognostic of function?

Answer 10

No. Various outcomes in function though all have cog. Deficits at 2 and 5 years if in MCS more 1 month

Question 11

If in MCS >1 month how long until stop functional improvement?

Answer 11

See improvement 2-5 years after inpatient rehab.

Question 12

Minimal disability rating scale (DRS) score for MCS or VS

Answer 12

16/29. Higher indicates more disability

Question 13

where is epidural space?

Answer 13

between inner surface of skull and tightly adherent dura.

Question 14

artery in epidural space? source? supplies?

Answer 14

middle meningeal artery (branch of external carotid artery) supplies dura

Question 15

where is subdural space?

Answer 15

between inner layer of dura and arachnoid

Question 16

veins in subdural space? go where?

Answer 16

bridging veins in subdural space drain cerebral hemispheres and en route to dural venous sinuses

Question 17

where is subarachnoid space?

Answer 17

between subarachnoid and pia

Question 18

what’s in subarachnoid space

Answer 18

CSF. major arteries of brain travel within this space then send smaller penetrating branches through pia.

Question 19

what is choroid plexus?

Answer 19

specialized vascular structure that produces CSF

Question 20

where is choroid plexus?

Answer 20

ventricles

Question 21

CSF circulation

Answer 21

choroid plexus produces CSF flows from lateral ventricle -> 3rd ventricel -> 4th ventricle -> subarachnoid space and up to arachnoid granulations to be reabsorbed into bloodstream.