TBI

Question 1

definition

Answer 1

TBI is a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions with an associated diminished or altered state of consciousness

physical injury to the brain by an external mechanical force or projectile, that results in loss of consciousness, post traumatic amnesia and neurological impairment

Question 2

Epidemiology

Answer 2

Inconsistency in the definition and classification of TBI limits accuracy of epidemiology
• Most common cause of death under the age of 35 years in most developed countries
• Most common cause of accidental death
• Most commonly the result of road accidents, industrial and sporting accidents, attempted suicides and interpersonal violence
• Males outnumber females by at least 2:1
In Australia, it is the second leading type of ABI (following stroke)
• The Australian Institute of Health and Welfare has reported a rate of 107 TBIs per 100,000 population
• 20% of TBI patients admitted to hospital have sustained moderate or severe head injuries (80% mild)
• Increasing number of elderly people injured from falls

Question 3

risk factors for TBI

Answer 3

young adult male
falls
transport - MVA
assault 
substance abuse
risk taking behaviour 
psychiatric disorder
limited educational attainment 
unstable work Hx

Question 4

sequelae

Answer 4

dependent on severity of TBI
physical and cognitive impairments vary as a consequence of the lesion severity and location as well as the nature of brain damage and complications
can have devastating impact on lifestyle/future aspirations, creating general health and social problems causing disruption for family members and marital strain, affecting role relationships and fostering economic hardship
• Individuals confront their disability for decades in a society which most commonly associates disability with the elderly or those with congenital intellectual disabilities

Question 5

common health issues in TBI

Answer 5

Seizures (early and late)
• Somatic complaints
• Headaches
• Dizziness
• Pain
• Sleep disturbances
• Post concussion syndrome (PCS)
• Mental health issues
• Depression
• Anxiety
• Schizophrenia

Question 6

cognitive issues in TBI

Answer 6

• Impaired memory
• Language difficulties • Planning
• Writing

Question 7

behavioural issues in TBI

Answer 7

Depressive temperament • Irritability
• Impatience
• Socialisation problems

Question 8

MOI

Answer 8

Neuropathological evidence suggests that there are several mechanisms of brain injury, some operating at the moment of impact and others as a consequence of secondary complications

Question 9

MOI can be direct or indirect

Answer 9

direct - direct blow to the head
can be blunt - acceleration - deceleration injury commonly resulting in multiple body injuries and widespread brain damage; may cause scalp in juries, skull deformation +/- #’s or depressed #’s +/- perforated dura mater and brain
or penetrating - open head injury in which the dura mater is breached; may be caused by external objects or bone fragments from a skull #

INDIRECT : impact from other part of the body