Traumatic Brain Injury Flashcards

1
Q

What are the 2 most common causes of TBIs

A

about 50% are from MVA
2nd most common are falls
especially in elderly

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2
Q

What type of brain matter is damaged with an acceleration/deceleration of the brain

A

damages gray matter

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3
Q

what is damaged with rotational force?

A

damages the white matter

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4
Q

what is damaged with shearing?

A

this is a diffuse axonal injury that damages teh corpus callosum, cerebellar and cerebarl peduncles and subcortical white matter as well as the long axons of fornix
most often the most disabling damage that can cause immediate LOC

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5
Q

what is a coup

A

direct injury

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6
Q

what is a counter coup

A

rebound effect that can be a more devestating injury

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7
Q

3 signs of basilar fracture

A
•	Periorbitial ecchymosis (raccoon sign)
•	Anosmia- absences of smell
•	CSF rhinorrhea
o	Fluid exiting the nose especially with lying down
o	Occurs from tearing of the dura
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8
Q

type of fracture highly associated with epidural hematoma

A

linear skull fracture

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9
Q

What is the difference between a subdural hygroma and hydrocephalus?

A
  • Subdural hygroma is a collection of trapped CSF in the subarachnoid space and acts like a subdural hematoma which is accumulation of blood under the dura
  • Hydrocephalus is CSF building up in the ventricles
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10
Q

Explain the vicious cycle of acute head injuries.

A

• Increased pressure occurs from the initial bleeding and swelling  limited blood flow  increased capillary dilation  increased edema lack of nutrients neuronal death  further swelling

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11
Q

What is the difference between decorticate and decerebrate posturing?

A
  • Decorticate posturing is cortical white matter damage and cortical structures (diencephalon) that involves LE extension and UE flexion
  • Decerebrate posturing is usually mid and upper brainstem damage that involves extension of all 4 extremities and is more deteriorating
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12
Q

What are the 3 types of hematomas

A

epidural
subdural
intracerebral

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13
Q

symptoms of epidural

A

• Epidural
o Develops between skull and dura
o Seen in more young patients
o Associated with linear skull fractures 90% of the time
o Headache, vomiting, decreasing neuro status
o “talk and die”
 Seem fine after brief LOC then sudden fast deterioration
o Half as common as subdural

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14
Q

symptoms of subdural

A
•	Subdural
o	Between dura and arachnoid
o	40 and older are susceptible
o	Alcoholics are vulnerable
o	Signs/symptoms are similar to epidural
	BUT seizures are much more common
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15
Q

symptoms of intracerebral

A
•	Intracerebral
o	Blood mass within the brain tissue
o	> 5 ml
o	Most often in temporal or frontal lobe
o	Associated with severe trauma
o	Significant focal neuro deficits
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16
Q

A patient has a TBI. 2 Weeks after the TBI, they have a seizure. Is this likely to recur?

A

• Can occur within minutes to hours after initial injury
• If it occurs > 1 week after injury it is likely to reoccur
o Increased likelihood with gunshot wounds, intracerebral hematomas and intracranial infections

17
Q

3 signs of hyrdroephalus

A

changes in personality
gait issues
urination issues

18
Q

3 signs tested with Glascow coma scale

A

eye opening
motor response
verbal response

19
Q

scores of glascow coma scale and meaning

A

• A lower score= worse prognosis
o 3 is the worst score
o 15 is a perfect score

20
Q

What are some common symptoms of post-concussion syndrome and what kind of time frame can they last for?

A
•	Complaints can last for days, weeks, months, even 1-2 years
o	Consist of headache,
o	 dizziness, 
o	incoordination of fingers/hands, 
o	staggering gait with stairs,
o	 decreased mental performance
21
Q

What are 3 factors that would predict a poor prognosis with a TBI?

A
•	Longer term seizures
•	Normal pressure hydrocephalus
•	Cognitive impairment
•	Emotional/behavioral impairments
•	Language/communication deficits
•	Motor impairments
o	Paralysis, loss of fractionation, action tremors, ataxia, apraxia, motor planning
•	Sensory impairments
•	Visual and perceptual impairments
•	Cranial nerve signs