TBI Intro & Pathophys: Focal Injury Flashcards
what is a TBI and what can it be caused by
- injury that disrupts the normal fxn of the brain
- caused by a bump, blow, or jolt to the head or penetrating head injury
- explosives
what % of people are not working 1 year post TBI
40%
what % of people have difficulty with social integration post TBI
33%
mortality rate for severe tbi
30-50%
mortality rate for moderate tbi
10-15%
what two groups are at more risk for tbi and what are their ages
- children: 0-3, 15-24
- older adults: over 75 had the highest numbers and rates of hospitalizations and deaths
are males or females more likely to be hospitalized and die from tbi
- males
- 2x more hospitalized
- 3x more likely to die
additional groups at risk for TBI
- racial/ethnic minorities: american indian/alaskan natives, black, hispanic populations
- service members and veterans
- homeless individuals
- incarcerated individuals
- domestive abuse survivors
- rural area dwellers
what are the most common causes for TBI
- falls
- MVA, MCA (including bicycle & auto-pedestrian)
- acts of violence
- sports
cause of TBI for children
- falls
- abuse
cause of TBI for adolescents & young adults
- falls
- assaults
- MVA
cause of TBI for older adults
- overwhelmingly fall related
mechanisms of TBI
physically acquired
- open head injury
- closed head injury
- deceleration injuries
- hemorrhage/hematoma
mechanisms of acquired brain injury
- chemical/toxic exposure
- hypoxia
- tumor
- infections
open injuries result from what
penetrating types of wounds
- gunshots
- knife
- sharp objects
what happens to the skull with an open injury
fractures or displaced
what happens to the meninges with an open injury
they are compromised –> infxn, impaired CSF, further bleeding
what is a closed TBI
impact to the head but the skull is not fx
what is only damaged with a closed injury
only cortical neuronal tissue is damaged
what happens to the meninges in the closed injury
they remain intact
primary brain injury results from
mechanical issue at time of trauma
focal injury
localized to area under site of impact or site opposite to site of impact
what injuries are focal injuries
- contusions
- lacerations
- hemorrhage and/or hematoma
- coup-contracoup injury
common sites for a focal injury
- anterior-inferior temporal lobes (blow to back of head)
- prefrontal lobes
diffuse injury
diffuse axonal injury (DIA)
epidural hematomas (EDH) occur where
btw the dura mater and the skull
when you have a epidural hematoma what happens with ur conscious level
with these injuries you become unconscious, wake back up abrupty then decline again
unconsciousness - alert - deteriorate
what may be required for epidural hematomas
craniotomies and hematoma evacuation
subdural hematoma (SDH)
rupture to the cortical bridging veins
develops btw the dura & arachnoid
blood leaks slowly over several hours or weeks
where are subdural hematomas most seen
in elderly after falls with a blow to the head
what are symptoms like with a subdural hematoma
similar to those of a CVA
if you have a small clot with a subdural hematoma what is typically done? what about a large one?
small: reabsorbed by the body
large: surgically removed
subarachnoid hemorrhage (SAH) occurs where
btw arachnoid and brain tissue
which is the most life threatening hemorrhage
subarachnoid
what does survival look like for a subarachnoid hemorrhage
1/3 will survive with good recovery
1/3 will survive with some degree of disability
1/3 will not survive
what is the common sequela for subarachnoid hemorrhage
vasospasm
intracerebral hemorrhage (ICH) occurs where
within the brain tissue itself
causes of ICH
significant head injury
what is the presentation look like for an ICH
stroke like presentation
common sequela for ICH
seizures
what are the focal hematomas
epidural hematoma
subdural hematoma
what are the focal hemorrhages
subarachnoid
intracerebral
focal contusions
bruising on the surface of the brian is sustained at time of impact
small blood vessels on the surface of the brain hemorrhage
coup lesion
contusion on the same side of the brain as the impact
contrecoup lesion
surface hemorrhages on the opposite side of the brain trauma as a result of deceleration
does contrecoup or coup injury cause more damage
contrecoup
most common structures involved with a contrecoup injury
anterior poles
underside of temporal and frontal lobes
