Traumatic Brain Injury Flashcards
(49 cards)
TBIs cause about ______ deaths per year in the US
52,000
TBIs cause the highest mortality in which two populations?
young (15-24)
and
old (over 65)
What is the leading cause of TBI in the US?
What are some other causes?
leading cause: MVC/MVA
other causes: falls, firearms, assault/violence, sports, alcohol
What is the Glasgow Coma Scale?
15 point scale used to rate mental status & function
used to rate severity of brain injury & predict outcome
What is the highest GCS score?
What is the lowest GCS score?
highest: 15
lowest: 3
When should the GSC score be performed?
at triage & repeatedly during evaluation
Why is it important to do multiple GSC score evaluations?
because any decrease in score is a danger sign
What are the 3 components of the GCS and how many grades are in each of them?
Eye reponse → 4 grades
Verbal Response → 5 grades
Motor reponse → 6 grades
GCS score fore minor TBI
13-15
GCS score for moderate TBI
9-12
GCS score for severe TBI
< 8
What are some things that indicate a patient is likely to NOT have a significant intracranial injury?
no HA
no vomiting
age is under 60
no intoxication
no deficits in short term memory
no physical evidence of trauma above the clavicles
no seizure
What are the 3 types of tissue deformation?
- compression- tissue compression
- tensile- tissue stretching
- shear- tissue distortion when tissue slides over tissue
What do we do with every p atient with a known or suspected TBI?
get a CT!
What are some signs of a basilar skull fracture?
CSF rhinorrhea or otorrhea
ecchymosis of the lids (racoon eyes)
ecchymosis behind the ear (Battle’s sign)
hemotympanum
Mild traumatic brain injury with complex pathophysiologic process induced by traumatic biomechanic forces
concussion
alteration in mental status with or without loss of consciousness
confusion
amnesia
HA
dizziness
delayed verbal responses
emotionality out of proportion
concussion
What are some signs of increasing intracranial pressure?
persistent vomiting
worsening HA
increasing disorientation
changing levels of consciousness
What will the CT scan show for a patient with a concussion?
all imaging will be grossly normal
What is the treatment for a concussion?
cognitive & physical rest
Management for concussion:
- no loss of consciousness
- post-traumatic amnesia or other signs lasting less than 30 minutes
athletes may return to play if asymptomatic for one week
Management for concussion:
- loss of consciousness for less than 1 minute
or
- post-traumatic amnesia or other symptoms for more than 30 minutes but less than 24 hours
athletes may return to play in 2 weeks if asymptomatic at rest & on exertion for 7 days
Management of concussion:
- loss of concussion for longer than 1 minute
or
- post-traumatic amnesia or other symptoms for longer than 24 hours
athlete may return to play in one month if asymptomatic at rest & on exertion for 7 days
bruise (like any other) but in an area of vital tissue
brain contusion
