TBI Flashcards
What is the leading cause of TBI?
falls (32)
MVA (19)
acts of violence
sports
What factors predict the outcome for TBI?
Amount of immediate damage from the impact or insult
Cumulative effects of 2◦ brain damage
Individual’s premorbid cognitive characteristics
substance abuse
personality
Primary Brain Damage:
DIA
focal injury
coup-contrcoup injury
Diffuse axonal injury (DIA):
disruption and tearing of axons and small blood vessels from shear-strain of angular acceleration > neuronal death and possible hemmhorage
Focal Injury:
contusions, lacerations, mass effect from hemorrhage and edema (hematoma)
Secondary Brain Damage:
hypoxic/ischemic injury
swelling/edema
electrolyte imbalance
Concussion
Loss of consciousness, either temporary or permanent
Results from injury or blow to head
Impaired functioning of the brainstem reticular activating system: may seen changes in HR, RR, BP
Open injuries:
Result from penetrating types of wounds Gunshots Knife Sharp objects Skull: fractured or displaced
What is compromised with an open injury?
meninges: risk of infection
Closed injury:
Impact to the head but the skull is not fractured
Neural (brain) tissue is damaged
Dura remains intact
Subtypes of closed injuries
Concussion Contusion Hematomas Locked-in Syndrome Acquired Brain Injuries
What is a concussion?
Momentary loss of consciousness & reflexes: Shearing forces disrupt synapses
Momentary loss of consciousness may or may not occur!
Symptoms of a concussion:
Dizziness Disorientation Blurred vision Difficulty concentrating Alternations in sleep patterns Nausea Headache Loss of balance
Retrograde amnesia
Loss of memory of events prior to injury
Post-traumatic amnesia:
Unable to remember or learn new information
Duration is a clinical indicator of severity of the injury
Coup lesion
Contusion on the same side of the brain as the impact
Contrecoup lesion
Surface hemorrhages on the opposite side of the brain trauma as a result of deceleration
Epidural hematoma:
between the Dura mater & the skull
Often seen after a blow to the side of the head or severe trauma from a MVA
Rupture of the Middle Meningeal Artery in the temporal fossa can cause epidural hematomas
Unconsciousness – Alert – Deteriorate
Subdural hematoma
Acute venous hemorrhage results because of rupture to the cortical bridging veins
Develops between the Dura & Arachnoid
Blood leaks slowly over several hours or weeks
Seen in elderly after falls with a blow to the head
Symptoms can be similar to those of a CVA
Locked-on-Syndrome
Complete paralysis of all voluntary muscles except those that control movement of the eyes
Individual remains conscious & possesses cognitive function
UNABLE to move
Causes of acquired brain injuries:
airway obstruction, near-drowning, MI, CVA, exposure to toxins, electrical shock or lightening strike
What do acquired brain injuries result from?
changes in the neuronal activity affecting physical integrity, metabolic activity or functional ability of the cell
Loss of consciousness for mild TBI
0-30 mins
Alteration of consciousness for mild TBI
brief, less than 24 hours
Post traumatic amnesia for mild TBI
less than 1 day
Loss of consciousness for moderate TBI
greater than 30 mins but less than 24 hours
Alteration of consciousness for moderate TBI
greater than 24 hours
Post traumatic amnesia for moderate TBI
greater than 1 day but less than 7 days
Loss of consciousness for severe TBI
greater than 24 hours
Alteration of consciousness for severe TBI
greater than 24 hours