39. Neuropsych Sequelae of TBI Flashcards Preview

M2 Psychiatry > 39. Neuropsych Sequelae of TBI > Flashcards

Flashcards in 39. Neuropsych Sequelae of TBI Deck (22)
Loading flashcards...

mechanisms of injury that occur as a result of TBI?

-diffuse axonal injury (inertial)
-impact forces (coup/contre-coup)
-secondary injuries
-neurochemical vulnerability (dysreg of nT systems)


when in the course of the TBI do secondary injuries appear?

later in the course.


distribution of TBI by age group?

peak in late teens/20s/30s (driving) and again in old age (falls)


definition of TBI. what does it result in?

def: force acting on the brain
result: disturbance in level of consciousness
(LOC not required)


good news and bad news about TBI?

GOOD: decr rate of mortality from TBI over past 30 yrs (we are saving more people)
BAD: incr number of young, otherwise healthy ppl with chronic neuropsych disabilities


is there a direct correlation between severity of TBI and clinical course?

generally there is a correlation, but sometimes people do much better/worse than severity of injury would predict.


what 3 datapoints do we use to categorize severity of TBI?

-duration of LOC
-Glasgow score
-duration of post-injury amnesia


difference between Mild TBI and Complicated Mild TBI?

Complicated Mild has + findings on imaging


relationship between neuropsych syndromes and TBI

TBI greatly increases risk of dev neuropsych syndromes (approx 50% will dev a neuropsych disorder)


how do contusions affect neural pathways?

can cause damage to white matter tracts: not as well preserved after TBI. seen on a scan compared to healthy control.


someone is anticoag and hits their head: recommendation?

definitely should be evaluated: even small bumps to someone who is anticoagulated can cause cranial hemorrhage


DAI (though diffuse) primarily affects what parts of hte brain?

sub-cortical white matter, corpus callosum


DAI: evolution?

damage at time of injury and evolves over time: have scans from 1d, 1w, and 4y post-injury and there is progressive loss of projections from corpus callosum to cortical areas.


what is the difference between a primary and a secondary injury?

Primary: occurs immediately (contusions, hemorrhage, DAI)
Secondary: evolves over time (release of nTs, edema, ischemia, hypoxia, incr ICP)


3 major categories of neuro psych sequelae as a result of TBI?

-dys-executive problems (social comportment, less motivation, decline in exec cognitive function like memory, attention, information processing)
-other cog deficits
-psychiatric disorders


what is the most common cognitive complaint after TBI?

memory. most commonly working memory, short term memory, encoding


in addition to memory and loss of exec function, what other problem is seen post-TBI?



what does this post-TBI dementia resemble?

alzheimer's. neuronal loss, gliosis, tau deposition


what predicts the neuro (psych/cognitive) sequelae?

the profile of the injury, the area damaged


lateral orbitofrontal circuit: controls what?

social comportment.
impulsivity, irritability, affect, awareness


anterior cingulate and medial frontal circuits control what?

motivation. (interest, initiative, drive)


dorsolateral prefrontal circuit controls what?

Exec functions: planning, problem solving, working memory