TBI

Question 1

TBI Etiologies

Answer 1

MVA, falls, contact sports, assaults, falls secondary to CVA, motorcycle or bicycle accident

Question 2

NTBI Etiologies

Answer 2

Disease: Meningitis, Epilepsy, Tumor, Encephalitis
CVA, aneurysm, sleep apnea, toxic/metabolic drug abuse
Anoxic Events (drowning, strangulation, attempted suicide)

Question 3

Glasgow Coma Scale

[Assessment]

Answer 3

Given by paramedics at the scene
Rate levels of consciousness
Eye opening, verbal response, motor response
RLAS 1, 2, 3

Question 4

Rappaport coma/near coma scale

[Assessment]

Answer 4

Auditory, command response, visual response, threat, olfactory, tactile, pain, vocalization/
Ask family to leave or prep them ahead of time

Question 5

Rancho Los Amigos

[Assessment]

Answer 5

Tests cognition
TBI only
Describes behaviors & progress through recovery
10 levels

Question 6

TBI signs & symptoms

Answer 6

• Left-sided weakness or paralysis
• Left visual field cut or deficit
• Left neglect
• Slurred speech, lack inflection/prosody
• Feeding or swallowing problems
• Disturbed orientation, visual perception, hand-eye coordination def.
• Prosopagnosia
• Attention, Memory, Executive function
• Unaware of errors, talk too much/little
• Diff. controlling impulses - no filter
• Loss of musical abilities

Question 7

Primary Consequences of TBI

Answer 7

• Cranial Nerve Damage
• Epidural Hematoma
• Subdural Hematoma
• Subarachnoid Hematoma
• Intracerebral Hematoma

Question 8

Secondary Consequences of TBI

Answer 8

• Cerebral Edema
• Traumatic Hydrocephalus
• Elevated Intracranial Pressure
• Alterations in the Blood-Brain Barrier

Question 9

Secondary Consequences

Symptoms

Answer 9

Represent brain’s physiologic response to trauma or failure of somatic functions.
Often more devastating than primary consequences.
Often die from these consequences.

Question 10

Impact of TBI on Cognition

Answer 10

• Early: intense cognitive supports (see if they attend)
• Middle: Moderate cognitive supports (fam. environment)
• Later: Minimal & variable cog. supports. (real-life settings/demands)

Question 11

Impact of TBI on communication

Answer 11

• Can’t put sentences together, memory deficits, attention problems
• Different recovery pattern than CVA
• TBI: Stair-step pattern
• Predictable sequence
• Loss of consciousness follows accident
• Gradual return to consciousness

Question 12

TBI Treatment

Answer 12

1st: increase part. by modifying daily routines including support by others
2nd: Improve performance of daily activities including compensatory procedures in everyday routines & context-sensitive practice
3rd: Reduce underlying impairment with compensatory procedures in varied contexts until internalized