Traumatic Brain injury

Question 1

Definition

Answer 1

CNS disorder involving one or more substructures of the CNS

Type of acquired brain injury caused by a traumatic event

Question 2

CNS or PNS

Answer 2

CNS

Question 3

Aetiology (cause)

Answer 3

Traumatic event

• rapidly moving hard object hits a stationary head
• rapidly moving head hits a stationary object

Multiple areas of the brain can be injured - multifocal, diffuse

Question 4

Pathophysiology

Answer 4

Traumatic event causes bleeding/swelling in the brain

• > increase in volume within the cranium
• > increase in intracranial pressure
• > initial and further injury from TBI

Question 5

Types of TBI and cause

Answer 5

• subdural haematoma: tearing of vein on subsurface of brain
• epidural haematoma: fracture of the skull -> meningeal artery -> bleeding into extradural space (skull and dura mater)
• diffuse axonal injury: tearing of axons within the brain -> widespread injury in the brain

Question 6

How is it diagnosed

Answer 6

1. clinical assessment
2. evidence of brain injury on Scans (MRI, CT)
3. Post-traumatic amnesia (PTA)

Question 7

Problems

Answer 7

1. sensory
2. motor
3. cognitive

Question 8

Typical management

Answer 8

Conservative

• managing on intracranial pressure
• medical management

Surgical

• craniectomy
• craniotomy
• extra-ventricular drain (EVD)

Question 9

Craniectomy

Answer 9

part of skull is removed and not replaced until months later (helmet worn)

Question 10

Craniotomy

Answer 10

part of skull is removed then replaced (in same surgery)

Question 11

Extra-ventricular drain (EVD)

Answer 11

drains intracranial pressure