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Flashcards in [MND] Traumatic Brain Injury Deck (16):

Traumatic Brain Injury can be defined as

Damage to the brain resulting from external mechanical forces, such as rapid acceleration or deceleration, impact, blast waves, or penetration by a projectile


Criteria for clinical identification includes one or more of the following:

- Confusion or disorientation
- Loss of consciousness
- Post-traumatic amnesia
- Other neurological abnormalities (i.e. seizure)



Motor vehicle accidents, construction and sports, countries such as the US common causes include violence

- Sporting accidents and falls are primary factors for those under 20 years of age
- Transport accidents are common cause sin the adult populations
- Falls is a common cause in older adults


Risk factors

Multiple. Range from substance and alcohol abuse to motorcyclists not wearing helmets.

Increased risk with young infants; adolescent males; risk taking behaviour; and older adults (falls)



NZ 20,000 to 30,000 cases per year
Every day 90 New Zealanders sustain a brain injury


Primary Injury refers to

The primary mechanical damage occurring at the moment of impact. Involves cortical contusions, lacerations, diffuse axonal injuries, and skull fractures


Secondary Injury refers to

Secondary damage, delayed non-mechanical damage. Can involve inflammatory responses, mitochondrial dysfunction, cerebral oedema, and haematoma's)


Primary Injury/Damage involves 3 main mechanisms:

1) Direct impact on the skull
2) Penetration through the skull into the brain
3) Collision between the brain substance and the internal structure


Risk factors for prognosis include

age, gender, education, personality, substance abuse, motor score on GCS, pupil reactions, hypotension, infections and surgical interventions


Differential diagnosis

Stroke (i.e. intracerebral haemorrhage)


Outcome Measures

Glasgow Coma Scale (and Paediatric Glasgow Coma Scale)
Functional Independence measure (FIM)


Coordination may be affected as a result of damage to the

Corticospinal tracts, basal ganglia, cerebellum, and sensory pathways.


Basal Ganglia lesions cause

Slowed initiation of movement and bradykinesia


Cognitive Impairments
Both long term and short term memory may be affected as a result of direct damage to the

temporal lobes and thalamus (note the hippocampus is in the medial temporal lobe)


Muscle weakness can be caused by injury to the

Corticospinal tracts


Visual system may be affected at the level of the optic nerve, or at the levels where there is processing or interpretation of visual stimuli .
The chance of visual disturbances in diffuse injures is high because

1/3 of the brain is involved in the processing of vision. This is important as vision plays a role in the guidance of movement and the maintenance of balance