TBI Flashcards
Type of damage that occurs when an OBJECT hits a stationary head
contusion
type of damage that occurs with rapid acceleration and deceleration ?
defuse axonal injury
which type of injury tends to be more severe ?
defused axonal injury has more extensive and widespread damage (also more unpredictable and involve more body parts) vs contusion is more localized impairments
type of damage that occurs when the HEAD hits a stationary object
Coup contrecoup
injury by sharp object
penetration
- open type of injury = higher chance of infection
- deficits depends on size and location
secondary effects of TBI
- increased ICP
- hypoxia ischemia
- edema
- infection
- post traumatic epilepsy
- hydrocephalus
what is normal ICP? What is considered increased ICP?
Normal: 0 -10 mmHg
Increased: > 20 mmHg
what are signs of increased ICP?
nausea visual disturbances due to papilledema drowsiness Altered consciousness vomiting
What can increased ICP result in? (what damage occurs)
- displacement in brain tissue
- ischemia
- hydrocephalus
what are secondary effects of TBI
- increased ICP
- hypoxia ischemia
- edema
- infection
- post traumatic epilepsy
- hydrocephalus
what is cerebral perfusion pressure? normal vs abnormal levels?
- the amount of pressure needed to maintain blood flow to the brain
- Difference between mean arterial pressure (MAP) and intracranial pressure (ICP)
- normal CPP: ≥ 70 mmHg
- CPP levels that cause ischemia: ≤ 40 -50
Glasgow Coma Scale
- rates the severity of coma/TBI
- three categories: eye response, verbal response, and motor response
- scores range: 3-15
- severe: 3-8
- moderate: 9 -12
- mild: 13- 15
coma
- Unconscious and unarousable
- No periods of wakefulness or eye opening in response to stimulation
vegetative state
- Lack of awareness / consciousness of themselves and environment
- Are arousable- either spontaneously or stimulus induced BUT responses are NOT sustained, reproducible, purposeful, or voluntary.
- no evidence of language compression or expression
- intermittent wakefulness with presence of sleep wake cycles
retrograde vs anterograde amnesia
- retrograde: unable to recall memories prior to injury
- anterograde: unable to recall memories post injury
minimally conscious state
clear demonstration of awareness of self and environment by one or more of the following:
- simple command follow
- gestural or verbal yes/no (does have to be accurate)
- intelligible verbalization
- purposeful behaviors
Westmead post traumatic amnesia scale
- Measures duration of post traumatic amnesia
- PTA is over when person can form new memories
- Mild: 5 - 60 mins
- moderate: 1 - 24 hours
- Severe: 1 -7 days
- very severe: 1- 4 weeks
- extremely severe: > 4 weeks
Leading cause of TBI? other causes?
falls 40.5% other/unknown 19% stuck by/against 15.5% MVA 14.3% assault 10.7 %
TBI deaths
- deaths male to female ratio: 3:1
- highest incident of death is ≥ 65 yo
most common location of intracerebral hematoma
frontal and temporal
stages for ranchos los amigos cognitive function
1: no response
2: general response
3: localized response
4: confused agitated
5: confused, non agitated, inappropriate
6: confused, appropriate
7: automatic, appropriate
8: purposeful, appropriate
what stage of the ranchos los amigos cognitive function would you use a behavioral plan?
level 4: confused, aggressive, inappropriate