TBI

Question 1

Secondary head injury

Answer 1

several hours after primary injury that causes progressive deterioration/internal bleeding

Question 2

What can happen 3 weeks after injury

Answer 2

multi-system failure

Question 3

Focal head trauma

Answer 3

localized damage

Question 4

Types of focal head trauma

Answer 4

laceration, contusion

Question 5

Contusion

Answer 5

bruising of brain tissue

Question 6

Coup

Answer 6

primary impact

Question 7

Contracoup

Answer 7

secondary impact

Question 8

Treatment of focal head trauma

Answer 8

observation of ICP/neuro, hyponatremia, fluid restriction

Question 9

Diffuse head injury

Answer 9

generalized damage

Question 10

Type of diffuse head injury

Answer 10

concussion, diffuse axonal injury (DAI)

Question 11

What does a GCS score of 13-15 mean

Answer 11

minor TBI

Question 12

What does a GCS score of 9-12 mean

Answer 12

moderate TBI

Question 13

What does a GCS score of 3-8 mean

Answer 13

severe TBI

Question 14

Epidural hematoma

Answer 14

injury to middle meningeal artery, causing bleeding between the dura and inner aspect of skull periosteum

Question 15

s/s of epidural hematoma

Answer 15

headache, n/v, focal neuro deficit, enlarged pupils, seizures, abnormal posturing, coma, death

Question 16

Diagnosis of an epidural hematoma

Answer 16

head CT

Question 17

Is an epidural hematoma a medical emergency

Answer 17

yes

Question 18

Subdural hematoma

Answer 18

accumulation of blood between dura and arachnoid layers of meningies

Question 19

Where does bleeding coma from in subdural hematomas

Answer 19

bridging veins

Question 20

Risk for subdural hematomas

Answer 20

ETOH abuse, anticoagulants, atrophy in the elderly

Question 21

s/s of subdural hematomas

Answer 21

n/v, vision problems, slurred speech, dizzy, unsteady gait, confusion, hemiparesis

Question 22

Acute subdural hematoma

Answer 22

onset of symptoms, up to 48 hours after injury

Question 23

Subacute subdural hematoma

Answer 23

48 hours to 2-3 weeks of symptoms

Question 24

Chronic subdural hematoma

Answer 24

symptoms last weeks to months

Question 25

Surgical evacuation of hematoma

Answer 25

burr holes, craniotomy, ICP monitor placement

Question 26

Nursing care of hematoma

Answer 26

frequent neuro checks, midline head positioning, HOB above

Question 27

Diffuse brain injuries

Answer 27

involve the brain as a whole

Question 28

Concussion

Answer 28

sudden temporary mechanical injury with disruption of neural activity and change in LOC

Question 29

Second impact syndrome

Answer 29

second injury occurs before brain recovers from the first

Question 30

s/s of second impact syndrome

Answer 30

cerebral edema, increased ICP, brain herniation, coma, death

Question 31

Post-concussive syndrome

Answer 31

when symptoms persist for an extended period of time

Question 32

Severe TBI

Answer 32

GCS 8 or under, decrease LOC, increased ICP, longer duration of post trauma amnesia

Question 33

Diffuse axonal injury

Answer 33

widespread damage to axons in white matter of cerebral hemispheres, basal ganglia, thalamus, brainstem

Question 34

s/s of diffuse axonal injury

Answer 34

decrease LOC, increased ICP, cerebral edema, hemorrhage

Question 35

When do diffuse axonal injury symptoms occur

Answer 35

12-24 hours after injuryW

Question 36

Type of diffuse brain injury

Answer 36

concussion, diffuse axonal injury, subarachnoid

Question 37

How do neurons and blood vessels get disrupted in diffuse axonal injury

Answer 37

shearing forces