Behavioral Science: Traumatic Brain Injury Flashcards Preview

MS2 Unit 3 > Behavioral Science: Traumatic Brain Injury > Flashcards

Flashcards in Behavioral Science: Traumatic Brain Injury Deck (15):
1

TBI definition

Injury to the head arising from a blunt or penetrating trauma, or from acceleration/deceleration forces resulting in one or more of the following:
- decreased LOC
- amnesia
- neurologic/neuropsychological abnormality
- skull fracture
- diagnosed intracranial lesions
- head injury listed as cause of death on death certificate

2

Mild TBI def

Traumatically induced physiological disruption of brain function at the time of accident AND/OR:
Focal neurological deficits that may or may not be transient BUT:
LOC does not exceed 30 min, GCS score between 13-15 30 min after impact and post-traumatic amnesia does not exceed 24 hours

3

Risk factors for TBI

Male, age 0-4, 15-24, 65+
- lower SES, Rx drug use, alcohol use, race/ethnicity, recurrent TBI

4

Mortality of TBI

men 3x more likely to die than women
highest rates in 65+

5

Leading cause of TBI by age

0-4: assault
15-24: MVC
65+: falls

6

Primary cause of TBI

Diffuse axonal injury
Vascular tear
Focal cortical contusions
Intracranial/extracerebral hemorrhage

7

Secondary cause of TBI

Ischemia, hypoxia
Vasospasm
Edema
Necrosis, apoptosis
Inflammation
Seizure

8

Diffuse axonal injury

Deceleration of the brain within the skull causing shearing or torsional forces of brain tissue

9

Neurometabolic cascade

- Hypermetabolic glycolytic state
- Decreased cerebral glucose metabolism
- Reduced cerebral blood flow and glucose delivery
- ENERGY CRISIS with mismatch of energy demand to vascular energy supply

10

Classification of TBI based on GCS

Severe: 3-8
Moderate: 9-12
Mild: 13-15

11

Systemic complications following TBI

SO MANY.
Autonomic dysregulation, pulmonary embolus, dysphagia, gastritis, delayed gastic emptying, neurogenic bladder, heterotopic ossification, electrolyte imbalance, hypopituitarism, spasticity, dysesthesia, headache, hydrocephalus, vasospasm, seizures, infxn, depression, anxiety, agitation, delirium sleep dysfunction.

12

Post traumatic agitation

- impulsive, impatient, low tolerance for pain
- explosive, unpredictable anger
- restlessness, pacing, excessive movement
- loud, rapid excessive talking

13

Treatment for post traumatic agitation

- environmental modifications
- Beta blockers, Antiepileptic/anticonvulsants, antidepressants, antipsychotics

14

Psych probs after TBI

Depression, GAD, OCD, PTSD in mild TBI

15

Substance misuse

Pre-injury: 2x rate of substance use compared to gen pop
Immediately post injury: decline in drug and alc
One year post injury: up to 1/3 hospitalized for TBI misuse alc/drugs