TBI Intro & Pathophys: Diffuse Injury Flashcards
what is a diffuse axonal injury
axon tears in half
what forces cause an axonal injury
acceleration, deceleration, rotational forces –> widespread shearing and retraction of damaged axons
most common cause of axonal injury
motorcycle / car accidents
what does an axonal injury result in
traumatic “micro bleeds”
significant neurological involvement
poor prognosis
what are the most affected areas with a axonal injury
corpus callosum
basal ganglia
brainstem
cerebellum
what secondary brain damage post TBI would someone get
electrolyte imbalance and mass release of damaging neurotransmitters
“metabolic cascade” apoptosis
what other physiological responses to an initial injury look like
- hypoxic/ischemia injury (respiratory, cardiovascular)
- swelling/edma: mass effect, with increased ICP
you get higher rates of herniation and death when what happens..
intracranial swelling found during secondary brain damage compared to primary injuries
what is the most common ABI
anoxic/hypoxic brain injuries
what is anoxic/hypoxic brain injuries
lack of oxygenated blood flow to the brain tissue
what is anoxic/hypoxic brain injuries caused by
cardiac arrest
CO2 toxicity
near drowning
severe internal/external bleeding –> systemic hypotension
when you have an anoxi/hypoxic brain injuries what does it typically result in?
what is the prognosis?
- results in global damage
- lower expected functional outcomes
- poor prognosis for cognitive function
what are some more vulnerable areas for an anoxic/hypoxic brain injuries
hippocampus
cerebellum
basal ganglia
primary blast injuries
- direct effect of blast overpressure on organs
- usually diffuse brain damage
primary blast injuries usually increase what
CSF or venous pressure
secondary blast injuries are what
shrapnel injury
what is a shrapnel injury
multiple injuries due to a high velocity explosives
what is a tertiary blast injury
direct blow to the head
what do blast injuries lead to
edema contusion DAI hematoma hemorrhage
retrograde amnesia
loss of memory of events prior to injury
post traumatic amnesia
unable to remember or learn new info
acute management diagnostic imaging
MRI
CT
PET: how the brain fxns
EEG: for seizures
what medication management do you use for brain injury
decreased BP and ICP decreased intracranial bleeding anti seizure decrease temp decrease infxn rate
surgical management
craniotomy
craniectomy
VP shunt, EVD
