TBI

Question 1

Define traumatic brain injury

Answer 1

a non-degenerative, non-congenital insult to the brain from an external force and subsequent complications which can follow and further damage the brain

Question 2

What is the epidemiology of TBI?

Answer 2

1. 349 people per 100,000
2. more men than women
3. primary ages are 15-24, and 75+

Question 3

What percentage to TBIs are moderate/severe?

Answer 3

32%

Question 4

What are the different types of TBI?

Answer 4

1. closed or penetrating
2. focal or diffuse

Question 5

What is a focal TBI?

Answer 5

produced by external force causing compression of tissue under skull at impact site (coup) or tissue opposite (contre-coup)

Question 6

What is a diffuse TBI?

Answer 6

caused by rapid acceleration and deceleration of the head causing widely distributed damage to axons

Question 7

What are the different stages of injury in TBI?

Answer 7

1. primary injury
2. secondary injury

Question 8

What is primary injury?

Answer 8

immediate tissue damage due to direct impact (e.g. axonal shearage or haemorrhage)

Question 9

What is secondary injury?

Answer 9

hypoxia in the minutes post injury (e.g. bruising, swelling, bleeding, clots, raised ICP)

Question 10

When can raised ICP develop?

Answer 10

in 24-48 hours post injury

Question 11

What is a coma?

Answer 11

a state of depressed consciousness

Question 12

How is coma severity measured?

Answer 12

by the Glasgow Coma scale

Question 13

What is post-traumatic amnesia (PTA)?

Answer 13

1. disorientation in time, place, and person, and/or inability to remember new experiences
2. can engage in conversation, but not remember what is happening from that point on
3. monitored over time

Question 14

What are the main cognitive TBI presentations?

Answer 14

1. attention
2. memory and learning
3. executive function
4. perception
5. behavioural or social interaction difficulties

Question 15

What percentage of TBI patients have a communication difficulty?

Answer 15

1. around 75%
2. they are commonly called cognitive linguistic deficits

Question 16

What communication difficulties commonly impact individuals with TBI?

Answer 16

1. language form intact, but language use poor
2. difficulty at level of interaction/discourse
3. may also have speech difficulties

Question 17

What are common cognitive linguistic deficit features?

Answer 17

1. WFD
2. difficulty with abstract language
3. difficulty with inferences and links
4. repetitiveness/perserveration
5. disorganised/confusing discourse
6. confabulation
7. lack of self monitoring/correction
8. failing to start/maintain convo
9. reduced awareness of turn taking
10. fail to read social cues/ see other points of view
11. not asking for clarification
12. over or under explaining

Question 18

What are the common impacts of TBI?

Answer 18

1. anxiety, mood disorders, fatigue
2. effect on relationships
3. employment rates reduce
4. reduced social activity/network

Question 19

What are the employment statistics for TBI?

Answer 19

80% pre-injury, 55% 3yrs later for moderate/severe

Question 20

What assessments may be used with TBI?

Answer 20

1. cognitive linguistic function assessment
2. questionnaires (client + carer)
3. functional assessment (e.g. MET)
4. insight, awareness, self monitoring
5. family and impact

Question 21

What does TBI rehabilitation focus on?

Answer 21

1. functional communication
2. improving discourse, social communication, quality of life
3. driven by client goals