Traumatic Brain Injury Flashcards
what are the common causes of TBI?
- motor veichle accidents
- cycling accidents
- sports injuries
- violence
name the three potential effects of head injury
- behaviour and personality changes
- cognitive impairment
- motor and sensory deficits changes
what are the behaviour and personality changes that can occur after TBI?
- anxiety
- depression
- loss of motivation
- difficulty controlling anger
- impulsivity
what are the cognitive impairments that can occur after TBI?
- problems with memory, attention and concentration
- low tolerance for noisy or stressful enviroments
- loss of insight and initiative
what are the potential changes in motor and sensory systems after TBI?
- loss of coordination
- muscle rigidity
- epilepsy
- difficulty speaking
- sight/ smell/ taste loss
- fatigue
- sexual problems
- paralysis
how do they access TBI?
The Glasgow Coma Scale (GCS)
what does GCS do ?
- monitors changes in conciousness
- monitors motor response, verbal response and eye opening
what does GCS scores mean?
- <8 is a severe head injury (coma)
- 9-12 is a moderate head injury
- > 12 is a mild head injury
what does GCS scores mean?
- <8 is a severe head injury (coma)
- 9-12 is a moderate head injury
- > 12 is a mild head injury
what are the three things GCS check?
- best motor response
- best verbal response
- eye opening
what is a closed head injury?
A trauma causes the brain to be violently shaken inside of the skull, such as a blast injury (no visible wound).
what is a crush injury?
when the head is sandwiched between two hard objects
what is an open/ penetrating injury?
when an object goes through the skull and enters the brain
What is a coup injury?
Primary injury caused when the head stops suddenly and the brain rushes forward. Brain incurs a primary impact injurt at the site of the skull strike as well as surrounding tissue
what is a contrecoup injury?
Secindary injury caused when the brain bounces off the primary surface of impact and goes on to impact the opposite side of the skull. The brain incurs a focal area of damage as well as damage to the nearby surrounding tissue.
what can contrecoup cause?
- confusion
- swelling
- blood clots
what is hyperflexion?
head recoils forward and stops. Occipital lobe strikes back of skull.
what is hyperextension?
Sudden backwards acceleration of skull. Once skull stops moving, the frontal lobe strikes the front of skull.
what is haematoma?
a localised pooling of blood
what is concussion?
temporary neuronal dysfunction
what is contusion?
bruising of brain on impact, damage to blood vessels
what is DAI (Diffuse axonal injury)?
damage to axons throughout brain
what is a haemorrhage?
bleeding from ruptured blood vessels
what is a secondary injury (intacranial)?
evolves over hours, days, weeks after impact
how does a secondary intractanial injury?
haematoma leading to increased intracranial pressure and shifting of brain tissue causes an increased pressure on brain tissue
name the key features of a secondary intracranial injury?
- brain swelling, cerebral oedema, hydrocephalus
- increased intracranial pressure
- intracranisl haemorrhages, traumatic haematomas, infections
- blood flow changes and metabolic changes
- epilepsy
- hypoxia-ischaemia (reduced oxygen to brain)
what is cerebral perfusion pressure
mean arterial pressure - intrcranial pressure
what should CPP not fall below? and what does it increase the risk of?
70 mmHg otherwise risk of hypoxia and ischaemia
what is the normal ICP (Intracranial pressure)?
7-15 mmHg
If a patient is drowsy and confused what is there ICP and GCS likely to be?
20 mmHg
With a GCS of 13-15
what does ICP stand for?
Intracranial Pressure
if a GCS was <8 what would you expect there ICP to be?
30 mmHg
what is intracranial pressure made up of ?
-Brain
-Blood
-CSF (cerebrospinal fluid)
what percentage of the brain makes up ICP?
80% of total volume, tissues and interstitial fluid
what percentage of the brain makes up blood?
