Traumatic BRain Injury Flashcards
Causes of TBIs?
MVA
Falls
Assaults
Age for TBIs?
Bimodal
2 mechanisms of TBIs
Focal: lesion, contusion, SDH, EDH
Acceleration-deceleration
Diffuse atonal injury
Diffuse axonal injury when you see it?
Delayed - weeks
MRI
What happens in acceleration-deceleration injury?
Diffuse axonal injury
How to assess severity of TBI? 2 ways
Length of time in LOC/Coma
Post-traumatic amnesia
When is PTA?
From time of TBI until their memory returns. Includes LOC.
When is PTA over?
12/12 on west mead for 3 days in a row
What is the Rancho Los Amigos LEvels of Cognitive Functioning Scale used for?
TBI, PTA
PTA hallmarks
Poor attention/concentration
Altered sleep/wake cycle
Fatigue
Irritable/agitated
Therapy for PTA?
ROM
Nutrition
Swallowing
DDX for PTA?
ICP Infection Alcohol Meds Pain
Environmental Mx of PTA?
Low stim
Structured enviro
Pharm Mx for PTA?
Propranolol
Mood stabilizers
No BEnzos or antipsychotics
Cognitive Rehab
Individualized, goal oriented
Interdisciplinary
What is cognitive remediation? How?
ADL based
Task and site specific
Verbal cues
Teach and supervised practice
When to use NEuropsycholigist?
Closer to after PTA transition period
6 areas of cognitions?
Attention Memory Language Visual-spatial Executive Function Personality
Symptoms of acceleration/deceleration injury?
Loss of smell : shear off CNI
Or cooking tastes bad
Dizziness
Visual probs
Post TBI can get what?
Seizures
Seizures that happen in hospital, likely to have D/c
Driving after TBI?
Cognition?
Function? ADLs ok?
Work/school
Vision
Important thing to do in TBI for patient, family, employer?
Education, Education, Education!
Why not alcohol/illicit drugs? Say to family?
SLOWS your recovery down.
Take home points in TBI?
Recognition
Early rehab
Limitations/expectations of rehab
Ongoing input/surveillance of TBIs
