Traumatic Brain Injury

Question 1

Definition of traumatic brain injury

Answer 1

Traumatically induced structural injury or physiological disruption of brain function as a result of external force to the head

Question 2

Criteria for TBI

Answer 2

One of the following: loss/decrease consciousness, loss of memory, alteration of mental status, neurological deficits, intracranial lesion

Question 3

Rating criteria for TBI

Answer 3

Gaslow coma scale (GCS - not that useful), Alteration of consciousness (AOC), Loss of consciousness (LOC), Post-traumatic amnesia (PTA)

Question 4

Description of mild TBI

Answer 4

GCS 13-15, AOC < 24 hrs, LOC 0-30 min, PTA <24

Question 5

Description of moderate TBI

Answer 5

GCS 9-12, AOC > 24 hrs, LOC 30 min - 24 hrs, PTA 24 hrs-7 days

Question 6

Description of severe TBI

Answer 6

GCS 3-8, AOC > 24 hrs, LOC > 24 hrs, PTA > 7 days

Question 7

Classification of skull fractures

Answer 7

Location, Pattern of fracture, Open vs. closed

Question 8

Signs of skull fractures

Answer 8

Raccoon sign (hematoma behind eyes) and Battle sign (hematoma behind ear)

Question 9

Appearance of epidural hematoma on CT

Answer 9

Lenticular shape on CT

Question 10

Appearance of subdural hematoma on CT

Answer 10

Hyperdense crescent shaped lesion

Question 11

Concussion

Answer 11

Same thing as mild TBI

Question 12

Coup brain injury

Answer 12

Injury site is the site of impact

Question 13

Contrecoup brain injury

Answer 13

Injury site is directly opposite site of impact

Question 14

Mechanisms of brain injury

Answer 14

Diffuse axonal injury from acceleration/deceleration leading to release of degradative enzymes that breakdown the axon; gun shots cause expansion/contraction of tissue that disrupts tissue surrounding the wound

Question 15

Risk of recurrent concussions

Answer 15

Increased risk of repeat concussions, more symptoms, may be serious and harder to resolve

Question 16

Second Impact Syndrome

Answer 16

Occurs in athletes w/ history of concussion following a relatively minor second impact, increased ICP, fatal

Question 17

Chronic Traumatic Encephalopathy

Answer 17

Repeated and untreated concussions that lead to damage over time

Question 18

Mandatory events

Answer 18

Involvement in a vehicle blast event, presence within X meters of a blast, blow to the head, exposure to more than one blast event