Traumatic Brain Injury

Question 1

What is TBI?

Answer 1

Brain cell damage from an external force

Question 2

Demographics

Answer 2

Leading cause of death and disability in children and young adults
Prevalence in the US is ~6 million (similar to stroke)
Bimodal distribution of age: 15-25 and >75 years
TBI is UNDER-ESTIMATED

Question 3

Aetiology of TBI:

Answer 3

Individual runs into, or is hit by a solid object

MVA most common cause

Question 4

Pathophysiology of TBI:

Answer 4

“Coup” and “contracoup”
Bruising
Tearing
Oedema

Question 5

Signs and symptoms (mild TBI)

Answer 5

Fatigue
Headaches
Visual disturbances
Memory loss
Poor attention/concentration
Sleep disturbances
Dizziness/loss of balance
Irritability-emotional disturbances
Feelings of depression
Seizures

Question 6

Treatment for TBI:

Answer 6

Surgical decompression
Spine stabilisation
Physical and occupational therapy
Treatment of co-morbidities
Counselling

Question 7

Classification of TBI:

Answer 7

Mild (concussion)
Moderate (Glasgow coma scale of 9-12 in first 24 hours hours post-trauma)
Severe (GCS

Question 8

GCS scores based on:

Answer 8

Eye-opening (e.g., spontaneous, only with noxious stimuli), none
Motor response (e.g., follows commands, abnormal flexion, no response)
Verbal response (e.g., oriented, confused, incomprehensible sounds, none)

Question 9

Benefits of exercise in TBI:

Answer 9

Protection against de-conditioning co-morbidities
• Exercisers had less depression
• Fewer symptoms (cognitive, somatic, communication) despite no change in disability
• Post-trauma symptoms are less severe in exercisers vs non-exercisers!
• Improved visual and auditory learning
- neuroprotective effects by activating specific neuronal circuits and increasing molecules that enhance synaptic plasticity