TBI

Question 1

Severity classification

Answer 1

Mild:
- Duration of unconsciousness <30 min
- GCS 13-15
- Post-traumatic amnesia <24hrs

Moderate
- Duration of unconsciousness 30 min to 24hr
- GCS 9-12
- Post-traumatic amnesia 1-7 days

Severe
- Duration of unconsciousness >24hrs
- GCS 3-8
- Post-traumatic amnesia >7 days

Question 2

TBI prev

Answer 2

50% of people experience TBI in their life
- Highest in early life, early adulthood and 65+
- More men than women

Mild TBI by far most common, symptoms usually resolve within weeks/months

Moderate; symptoms may never disappear

For severe, mortality rate is 30-50%

Question 3

Presentation of TBI symptoms

Answer 3

Can be cognitive and/or behavioural

Differs across age groups;
- Complaints cognition and disturbances balance and mobility more common than in younger adults
- Complaints headache, light/noise sensitivity, irritability less common than in younger adults

Outcome is usually worse for elderly than younger, even with similar severity
- part due to comorbid conditions
- However; studies on this often don’t correct for normal ageing.

Overall:
- Higher education and pre-morbid IQ is associated w better outcomes on cognition

Question 4

TBI as risk for dementia

Answer 4

TBI can result in increased AB levels in the grain

TBI can result in misfolding of TAU and detaching from the microtubule, leading to accumulation of TAU

TBI reduces the cognitive reserve

The exact link is difficult to establish, but it has been shown that TBI in early life increases the risk for AD diagnosis.
- Also, TBI in early life leads to earlier onset of MCI and AD (even mild TBI)
- TBI increases the risk for bvFTD (1.6-4.4x)
- TBI leads to earlier onset bvFTD (3.2 yrs)

TBI in later life increases risk as well, but difficult to say which came first. furthermore, compared to other risk factors, that of TBI is small

Question 5

Multiple TBIs

Answer 5

Common in sports and military
- could increase risk for dementia and other neurodegenerative diseases.
- Retired NFL players 3x higher to die from AD or ALS than general population
- Repeated TBI associated w CTE

Question 6

CTE

Answer 6

Chronic Traumatic Encephalopathy: a progressive, degenerative brain disease that occurs in people who have had repeated traumatic brain injuries (TBI)—such as concussions or even mild, repetitive head impacts.

Hallmark of CTE is the abnormal buildup of tau protein in brain cells (neurons), especially:
- Around small blood vessels
- In the depths of brain sulci

Common symptoms include:
- memory impairments, planning difficulties, depression, apathy, impulsive behaviour
- Similar to AD symptoms