TBI Flashcards
______ = change in brain function due to external force
TBI
____ is the leading cause of death in people under than 45 y/o in Canada
TBI
MVA’s account for __% of the severe TBI;s in adults and ___% in children
60;92
_____ TBI = meninges not breaded and does not require hitting head
closed
_____ TBI = meninges breathed, exposes brain or laceration
open
What are 6 mechanisms of injury in TBI?
- coup
- contre-coup
- bruising
- axonal tearing
- shearing
- anoxia injury
What are 6 mechanism that occur in coup and contre-coup injury?
- primary mechanical injury
- secondary mechanical injury
- ischemia
- edema
- shearing forces
- torsion forces
Why is shaken baby syndrome so traumatic to childrens brains?
bc they lack the neck muscles to stabilize their head
Being in close approximation to an explosion can cause ____ syndrome.
blast
_______ injury = damage caused at time of impact, can be local or diffuse
primary
In a primary brain injury, the diffuse axonal injury is due to both _______ and ______ forces.
shearing; deceleration
______ ______ _____ = shearing of the brains long connecting nerve fibres (axons)
diffuse axonal injury
DAI occurs when the brain is injured as it ____ and _____ inside the bony skull
shifts; rotates
DAI usually causes ____ and injury to many different parts of the brain.
coma
Changes in DAI can be detected by CT and MRI scans. (T/F)
FALSE; often microscopic
__________ injury is related to trauma
secondary
Auto-regulation of cerebral blood flow may be lost after head injury, leading to ____ systemic BP.
low
Raised _____ _____ _____ is serious and often fatal.
inter-cranial pressure
If the underlying cause of raised ____ is treatable the outlook generally looks better for pt’s.
ICP
Post-traumatic ________ occurs in 2-5% of TBI and is more common with severe or penetrating injuries.
epilepsy
Most seizures due to TBI occur immediately after the injury or within the ____ year.
first
Post-traumatic epilepsy may surface years later (T/F).
TRUE
Second point were seizure disorder emerges is __-__ months post injury.
9-12
______ = altered state of consciousness that may be very deep (unconsciousness) so that no amount of stimulation will cause the pt to respond.
coma
_____ can be a state of reduced consciousness, so that the pt may move about or respond to pain.
coma
The depth of the coma and the time a pt spends in a coma varies greatly depending on the ________ and ______ of the brain injury.
location; severity
What are the 3 categories of the glasgow coma score?
- eye opening
- verbal response
- motor response
Is a higher or lower score on the glasgow coma scale more favourable?
higher
How do you score the glasgow coma scale?
add the 3 category scores together
What is mild for the glasgow coma scale?
13-15
What is moderate for the glasgow coma scale?
9-12
What is severe for the glasgow coma scale?
<8
Extension posturing?
decerebrate rigidity
Abnormal flexion?
decorticate
Is decerebrate or decorticate positioning worse?
decerebrate
Is lower or higher worse in the Rancho levels of Cognition?
Lower
___ - ___ % of pt’s with severe head injury have C spine injury
5-10
Patients with GCS less than __ require early intubation.
8
What is the full assessment of of acute head injuries?
- GCS
- pulse, BP
- assessment of pupil diameter and response
- assessment of limb movement
What are the 8 deficit categories seen in TBI?
- cognitive
- motor
- sensory
- communication
- functional
- social
- regulatory
- personality
What are the 5 outcomes int he Glasgow Scale?
- good recovery
- moderate disability
- severe disability
- vegetative state
- dead
The treatment for TBI takes an average of __-__ months.
3-6
Recovery may take place for ____ following an injury.
years
What are the two factors influencing the nature of the acquired brain injury?
- unilateral vs. bilateral/brainstem
2. extent of brain damage
What are the 4 factors influencing outcome?
- Nature of acquired brain injury
- premorbid health
- family support
- age
Rehabilitation begins during the ____ treatment phase.
acute
Goal of ______: to help the patient return to the highest level of function and independence possible, while improving the overall QOL - physically, emotionally and socially.
rehabilitation
What 5 things does the success of rehabilitation depend on?
- nature and severity of brain injury
- type and degree of resulting impairments
- overall health/age
- maximizing pt’s capabilities at home/community
- positive reinforcement promotes self-esteem/independence
concussion = ____ TBI
mild
Grade __ concussion: does not lose consciousness, dazed
1
Grade __ concussion: does not lost consciousness, period of confusion, does not recall event
2
Grade __ concussion: classic concussion, loses consciousness for a brief period of time
3
Grade 3 concussion = __ memory of the event, requires evaluation ASAP
no
What are the 5 post concussion syndrome symptoms?
- persistent headaches
- dizziness
- irritability
- memory changes
- vision changes
Symptoms may begin _____ or even _____ after the initial injury.
weeks; months
Seriously increased risk if _____ concussion before symptoms of initial one has resolved.
second
_____ tissue damage associated with concussion.
subtle
_______ may provoke or increase post-concussion symptoms if done too leary,
exertion
Patients in strict _____ condition experience higher total symptoms.
rest
What 3 things may aerobic exercise improve in concussion?
- reduced cognitive impairment
- facilitate neuroplasticity
- improve learning outcomes
_____ _____ _____ is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well asymptomtic subconcussive hits to the head
CTE
Neuropathological hallmark of CTE = ____ deposits
tau
