TBI Flashcards
Define traumatic brain injury
a non-degenerative, non-congenital insult to the brain from an external force and subsequent complications which can follow and further damage the brain
What is the epidemiology of TBI?
- 349 people per 100,000
- more men than women
- primary ages are 15-24, and 75+
What percentage to TBIs are moderate/severe?
32%
What are the different types of TBI?
- closed or penetrating
- focal or diffuse
What is a focal TBI?
produced by external force causing compression of tissue under skull at impact site (coup) or tissue opposite (contre-coup)
What is a diffuse TBI?
caused by rapid acceleration and deceleration of the head causing widely distributed damage to axons
What are the different stages of injury in TBI?
- primary injury
- secondary injury
What is primary injury?
immediate tissue damage due to direct impact (e.g. axonal shearage or haemorrhage)
What is secondary injury?
hypoxia in the minutes post injury (e.g. bruising, swelling, bleeding, clots, raised ICP)
When can raised ICP develop?
in 24-48 hours post injury
What is a coma?
a state of depressed consciousness
How is coma severity measured?
by the Glasgow Coma scale
What is post-traumatic amnesia (PTA)?
- disorientation in time, place, and person, and/or inability to remember new experiences
- can engage in conversation, but not remember what is happening from that point on
- monitored over time
What are the main cognitive TBI presentations?
- attention
- memory and learning
- executive function
- perception
- behavioural or social interaction difficulties
What percentage of TBI patients have a communication difficulty?
- around 75%
- they are commonly called cognitive linguistic deficits
What communication difficulties commonly impact individuals with TBI?
- language form intact, but language use poor
- difficulty at level of interaction/discourse
- may also have speech difficulties
What are common cognitive linguistic deficit features?
- WFD
- difficulty with abstract language
- difficulty with inferences and links
- repetitiveness/perserveration
- disorganised/confusing discourse
- confabulation
- lack of self monitoring/correction
- failing to start/maintain convo
- reduced awareness of turn taking
- fail to read social cues/ see other points of view
- not asking for clarification
- over or under explaining
What are the common impacts of TBI?
- anxiety, mood disorders, fatigue
- effect on relationships
- employment rates reduce
- reduced social activity/network
What are the employment statistics for TBI?
80% pre-injury, 55% 3yrs later for moderate/severe
What assessments may be used with TBI?
- cognitive linguistic function assessment
- questionnaires (client + carer)
- functional assessment (e.g. MET)
- insight, awareness, self monitoring
- family and impact
What does TBI rehabilitation focus on?
- functional communication
- improving discourse, social communication, quality of life
- driven by client goals
