TBI Flashcards
what defines a TBI?
Any impact or shaking of brain that stretches neurons
why are reports of 1.7 million TBI under representative?
some don’t know they have one
some don’t have health insurance
some don’t take it seriously
what % of concussions are mild TBI? What is mild TBI?
75%
concussion
what populations have the highest rate of TBI?
Infants, teens and seniors
WHich population is at highest risk to die from TBI?
seniors
what sex have higher prevalence of TBI?
males
What causes TBI in children and elderly?
Children most likely to get TBI from falls b/c they are learning to walk
Elderly is most likely to get TBI from falls b/c they are losing coordination
what causes TBI in teens?
most likely to get TBI from MVA’s due to risk taking behavior
what are the 3 factors that determine severity of TBI?
- Duration of Unconsciousness or altered mental status
- Duration of Post-Traumatic Amnesia
- Initial Glasgow Coma Score
what are the 3 categories of the Glasgow Coma Score?
eye responses
verbal responses
motor responses
what are the 4 points a pt could get for eye responses?
- No eye opening
- Eye opening to pain
- Eye opening to verbal command
- Eye opens spontaneously
what are the 5 responses a pt could get for verbal responses?
- No verbal response
- Incomprehensible sounds
- Inappropriate words
- Confused
- Oriented
what are the 6 responses a pt could get for motor responses?
- No motor response
- Extension to pain
- Flexion to pain
- Withdrawal from pain
- Localizing to pain
- Obeys commands
what are the 3 grades for the glasgow coma score?
Mild: GCS 13-15
Moderate: GCS 9-12
Severe: GCS 3-8
what are the 3 grades for loss of consciousness?
mild: 24 hours
what are the 3 grades of post traumatic amnesia?
mild: < 24 hours
moderate: 1-7 days
severe: > 7 days
do OT’s use the glasgow coma scale to tx pt?
no, must tx symptoms and functioning which arent indicators of severity
what are the 2 types of TBI?
- Closed-head (majority)
2. Open/penetrating
what does the sequelae of TBI affect?
cognition
behavior
physical/sensory
how long does it usually take mild TBI to heal and return to fxing?
3 months to be free of symptoms
what are the most common chronic symptoms of TBI?
headaches
fatigue
irritability
what are chronic cognitive symptoms?
Impaired Attention: i.e. sustained attention, selective attention
Impaired Memory: i.e. long term (semantic, episodic), short term
Impaired Speed of Info Processing
Perseverations
what are chronic physical symptoms?
Fatigue Headaches Dizziness Sensitivity to Noise/Light: esp. in acute phase. i.e. phonophobia, photosensitivity Insomnia Paresis/loss of sensation Weakness
what are chronic behavioral symptoms?
Emotional Lability Irritability/loss of temper Anxiety Depression Personality Changes
how does TBI cause symptoms?
Axonal death - excitatory
Axonal stretch & disconnection
what occurs during diffuse axonal injury?
Rotational Acceleration-deceleration
Tearing and Shearing of Axons
Most axonal death hours after injury
what occurs during Persistent Vegetative state of coma?
Deep state of unconsciousness
Sleep-wake cycles
what occurs during minimally conscious state of coma?
Little awareness & responsiveness
can respond to some stimuli
what occurs during post traumatic amnesia state of coma?
Disoriented and confused
Lack of memory post head injury
