TBI (Exam #3)

Question 1

With TBI classification, what GCS score constitutes mild vs. moderate vs. severe?

Answer 1

• Mild = 13-15
• Moderate = 9-12
• Severe = 3-8

Question 2

What condition involves functional changes but NO structural changes; GCS 13-15?

Answer 2

Mild TBI (mTBI) = concussion

Question 3

What is the Cushing Reflex, and what are the three components?

Answer 3

• HTN
• Bradycardia
• Irregular breathing

Question 4

What is the test of choice for a TBI?

Answer 4

CT head WITHOUT contrast

Question 5

What are the two main goals of tx for TBI?

Answer 5

• Maintain cerebral perfusion/oxygenation

- Prevent secondary injury

Question 6

What is the recommended disposition for Mild TBI (mTBI)/Concussion? What three pieces of “education” should be given?

Answer 6

24+ hours of observation

• Written education and F/U required
• If sxs, cognitive rest for 1-2 days
• Gradual return to work, school, sports

Question 7

What is the recommended disposition for Moderate/Severe TBI?

Answer 7

Neurosurgical intervention

Question 8

What medication may be recommended for Moderate/Severe TBI, and what two conditions must be met in order to give it?

Answer 8

Tranexamic Acid

• GCS of 8-13
• Within 3 hours of injury

Question 9

What are three possible complications associated with TBI?

Answer 9

• Post-Concussion Syndrome
• Second Impact Syndrome
• Traumatic Encephalopathy

Question 10

What two sxs are often seen with Post-Concussion Syndrome?

Answer 10

• HA

- Dizziness

Question 11

What is the tx for Post-Concussion Syndrome?

Answer 11

REASSURANCE

• Rest
• Written education
• F/U imaging, referrals PRN

Question 12

What is Second Impact Syndrome?

Answer 12

Second trauma occurs prior to resolution of TBI sxs

- Rare but can be fatal

Question 13

What is Traumatic Encephalopathy?

Answer 13

Recurrent TBI → progressive neurodegenerative disease

Question 14

What may be seen with Traumatic Encephalopathy post-mortem?

Answer 14

Tau protein accumulation