TBI Flashcards
Open Brain Injury definition
Result of direct penetration through the skull to the brain
i.e. knife/sharp object penetration, gunshot wound, skull fragments, direct trauma
Closed Brain Injury definition
Injury to the brain without penetration through the skull
i.e. concussion, contusion, hypoxia, drug OD, near drowning, acceleration/deceleration injuries
Primary Brain Injury definition
The initial injury to the brain sustained by impact. Can be coup lesion or contrecoup lesion (rebound effect)
i.e. skull penetration, skull fracture, contusions to gray/white matter
Secondary Brain Injury definition
The brain damage that results from the initial injury.
i.e. hematoma (subdural or epidural), increased IC pressure, post-traumatic epilepsy, ischemia, hypoxia
Levels of Consciousness (6)
1) Coma
2) Stupor
3) Obtundity
4) Delerium
5) Clouding of consciousness
6) Consciousness
Coma characteristics
unresponsive to all internal/external stimuli
Stupor characteristics
General unresponsiveness
Can be aroused by repeated stimuli
Obtundity characteristics
“conscious” but:
State of sleep
Reduced alertness to arousal
Delayed responses to stimui
Clouding of Consciousness characteristics
conscious but quiet behavior confusion poor attention delayed responses
Consciousness characteristics
alert
aware
oriented
memory intact
Grade 1 Concussion
No loss of consciousness
Transient confusion that resolves in 15 mins
Full memory of event
Remove athlete from game and only RTP if symptom free after 1 week
Grade 2 Concussion
Result of moderate head injury
Transient confusion > 15 minutes
Poor concentration, retrograde, and antegrade amnesia
Remove athlete and medically evaluate
CT indicated if symptoms worsen
Defer RTP until asymptomatic at rest and exertion for 2 weeks
Grade 3 Concussion
Resultant of diffuse axonal injury Loss of consciousness Transport pt to ER for neuro eval Hospitilization required if altered consciousness/mental status persists Withold RTP for at least 1 month
