traumatic brain injury Flashcards
acquired brain injury
can be traumatic, non-traumatic as a result of stroke, infection, tumor, surgical complications, seizures, endocrine disorders, drug reactions, environmental toxins and anoxia- lack of o2
facts about acquired BI and TBI
ABI0 more common in male than female, TBI- increased by 6% since 2005/6, peak rusk in age 16-25
traumatic brain injury
an injury the brain caused by a trauma to be held (head injury). there are many possible causes, including road traffic accident, assaults, falls and accidents at home or work
TBI causes
automobile accidents, sli[[ing/falling, something falling or being thrown that strikes the head, being shaken violently, sports-related events of activities, acts of violence, can be linked to suicide attempts- cognitive problems (BPS)
types of TBI- closed head injuries
these account for the majority of brain injuries and occur when the brain is rattled or traumatized inside the skull.
types of closed head TBI
diffuse axonal injury- coup- contrecoup- Closed head injury (coup contrecoup) can damage more than the impact sites on the brain, as axon bundles may be torn or twisted, blood vessels may rupture, and elevated intracranial pressure can distort the walls of the ventricles.
concussion- temporary disruption of brain function, intracranial hematoma- ruptured blood vessels in a pool of blood, cerebrain contusion- bleeding in brain
open wound injuries
these injuries are often life threatening and occur when a blow to the head occurs that is forceful enough to penetrate the skull
crushing injuries
these types of injuries occur when the brain is compressed between 2 objects. although rare, these are the most damaging and life threatening TBI
immediate S and S of TBI
difficulty in concentrating and confusion, changes in consciousness, headaches/ dizziness, vomiting and nausea, changes in mood/ behaviour and personality, dilated pupils, swelling at site of suspected brain injury, inability to remember, difficulty breathing, fluid leaking from nose/eyes/ ears- cerebrospinal fluid, language difficulties, changes in vision- blurred, hallucinations
TBI severity- loss of consciousness, post traumatic amnesia
minor brain injury- 15mins, <1 hour
moderate- 15 mins-6 hours, 1-24 hour. severe brain injury- 6-48 hours, 24 hours= 7 days
very severe brain injury- >48 hours,, >7 days
coma and reduced awareness state- vegetative state
severe, have sleep= wake cycles but no conscious awareness of themselves and their surroundings
coma and reduced awareness state- minimally conscious state
shows distinct but limited signs awareness and response to stimulation. very difficult to remain aware or responsible for any length of time or in a predictable way
coma and reduced awareness state- locked in syndrome
this is a rare condition in which a person is aware of themselves and their surroundings but is unable to move or speak often people can move their eye of eyelids and may be able to communicate by blinking
what is an anoxic brain injury
occurs when the brain is depleted of oxygen, left without oxygen for too long, neural cells begin to die through a process called apoptosis. when a large number of brain cells simultaneously di, patients can be left with diminished brain function
causes of anoxic brain injury
stroke or RIA, anaphylactic shock, electrocution, extremely low BP, severe pneumothorax or collapsed lung, oxygen deprivation at birth, a physical attack or assault, asphyxiation (choking), drug overdose
how long can the brain survive without oxygen
the brain can survive 4 mins without oxygen, so action is required immediately, 30 secs in can cause brain injury, 2 mins in damage becomes inevitable
types of anoxic brain injury- diffuse cerebral hypoxia and focal cerebral ischemia
diffuse- this is a mild to moderate injury that causes minimal brain impairment due to low blood oxygen levels
focal- this is a oxygen deprivation, usually due to a stroke, that occurs in a single area of the brain. the brain region may be affected, while other areas of the brain are left unharmed
types of anoxic brain injury- global cerebral ischemia, cerebral infraction
global- this is a complete cessation of blood flow and oxygen to the brain, and typically causes catastrophic harm
cerebral- this is a brain injury due to a stroke that completely deprived multiple brain regions of oxygen, leading to serious side effects
immediate S and S anoxic brain injury
confusion, loss of consciousness, feeling dizzy, intense headache, vomiting, changes in behaviour or sensation- arms/legs- tingly
S and S of acquired brain injury- temporal lobe, parietal lobe
temporal- spoken word, selective attention, aggression, identification, categorization, recognising objects
parietal- object classification, tactile processing, academic skill sets fall, cognitive ability decreases
, direction understanding, hand-eye coordination
S and S of acquired brain injury- frontal and occipital
frontal- emotions, personality, initiation of movement
occipital- vision, vision fields, locating objects, colour identification, hallucination, inability to perceive the way in which objects move, reading/writing, visual processing
S and S of acquired brain injury- cerebellum and brain stem
control of gross/ fine coordination, voluntary motor skills, balance, equilibrium, postural control ,eye movements
brain stem- body temp regulation, HR and breath regulation, balance, movement, swallowing, vertigo, nausea
signs and symptoms
changes in behaviour or personality, difficulty with previously on challenging tasks, changes in relationship, difficulty with short or long term memory, trouble recognizing familiar people, new fears, psychosocial symptoms- depression/anxiety, headaches, unexplained pain
tests
angiogram of brain, blood tests, CT scan of head, ECG- view ehart, brain waves, evoked potentials- tests certain sensations, MRI
immediate medical management fo ABI
breathing assistance (mechanical ventilation) and oxygen, controlling the heart rate and rhythm, fluids, blood products, or medicines to raise BP, medicines or general anesthetics to calm seizures
medication
anticonvulsants, antidepressants, antipsychotics, pain management, antispasmodics, memory and attention
glascow coma scale and mortality
3- 65%, 4-45%, 5- 35%, 6- 24%, 7-13- 10-15%
what does prognosis depends on
age- recovery prognosis declines with age, location of contusion of the brain, length of time spent in coma- paired with post-trumatic amnesia, this can dictate how long the recovery period will take
