Question 1

Moderate to severe traumatic brain injury (TBI)

Accepted Answer

results from damage to brain tissue caused by an external mechanical force, can include: loss of consciousness post-traumatic amnesia (PTA) positive neuroimaging, or objective neurological findings attributed to TBI on physical or mental status examination

Question 2

Uncomplicated mild traumatic brain injury (mTBI)

Accepted Answer

"concussion: Involves a traumatically induced physiological disruption of brain function that results in a graded set of clinical symptoms that most often resolve spontaneously. Alteration or loss of consciousness and other transient neurologic signs are typically used to define mTBI.

Question 3

Primary Injury examples of TBI

Accepted Answer

skull fracture contusion subarachnoid hemorrhage mechanical injury to axons and blood vessels. Because of the anatomical arrangement of the brain and skull, focal injury is most common in the frontal and temporal lobes. Diffuse axonal injury tends to be most prominent at the gray–white matter junctions.

Question 4

Secondary Injury examples of TBI

Accepted Answer

Hypoxia ischemia swelling/edema hypotension mass lesions increased intracranial pressure (ICP) poor cerebral perfusion pressure.

Question 5

Risk factors for TBI based on age

Accepted Answer

0-7 years: falls or child abuse 15-24: motor vehicle related injuries 65+ falls

Question 6

Risk factors that increase the likelihood of persistent problems (>3 months post injury) after mTBI include:

Accepted Answer

- medical factors (prior neurological injury, recent/multiple mTBIs, chronic pain or medical conditions) - demographic (female, less education) - mental health (depression, substance use, misattribution bias) - secondary gain (litigation, disability incentives)

Question 7

Rates of TBIs

Accepted Answer

mild: 70-80% moderate: 20% severe: 15-20%

Question 8

mTBI but with positive neuroimaging is called

Accepted Answer

complicated mTBI Functional outcome after such injury tends to be similar to moderate TBI.

Question 9

Classification of TBI severity can be accomplished using a combination of various indicators:

Accepted Answer

Glasgow Coma Scale (GCS) score Time to follow commands (TFC) Length of PTA however, no universally accepted TBI classification system exists

Question 10

Recovery after moderate to severe TBI often takes more than

Accepted Answer

1 year

Question 11

Two general approaches to cognitive rehabilitation

Accepted Answer

restorative skills training - focus on treatments intended to reinforce or directly improve specific cognitive domains compensatory skills training - teach patients strategies to compensate and adapt to cognitive impairments computer- based cognitive rehabilitation has very limited utility in improving function. Instead, broad-based, real-world training in problem solving and compensatory techniques tends to be the most effective treatment.

Question 12

TBI neuropsychological expectations

Accepted Answer

"Hold tests" (vocabulary, information) are generally unaffected Processing speed (most commonly impacted d/t impact on white matter integrity) Complex attention problems (divided) - children who sustain moderate to severe TBI may develop secondary ADHD. Possible visual spatial difficulties secondary to EF Memory, again possible d/t EF - reduced processing speed, learning capacity, and organizational skills, thus leading to faulty encoding, storage, and retrieval. Depression and anxiety are common following TBI

Question 13

Chronic Traumatic Encephalopathy (CTE)

Accepted Answer

a unique distribution of p-tau accumulates in the depths of the cortical sulci, which in turn is associated with severe behavioral, cognitive and mood changes in older adulthood. BUT Recent comprehensive literature reviews suggest that the neuropathological changes described in CTE are not unique to that condition, and that a sizable percentage of persons who have such changes will not develop dementia or commit suicide.

Question 14

Glasgow Coma Scale (GCS)

Accepted Answer

A scale that assesses responsiveness in patients who have sustained brain injury. There are three parameters: eye opening, motor response, and verbal response. The scale ranges from 3 to 15, with scores of 8 or less indicating severe injury and scores over 13 associated with mild injuries. It is common to use the term “complicated mild” with GCS over 13 in the context of positive acute neuroimaging findings. In severe TBI, lower GCS (3 to 5) is clearly associated with increased mortality rates.

Question 15

What is the best predictor of TBI prognosis?

Accepted Answer

PTA

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Traumatic Brain Injury Flashcards

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