Week 4 Flashcards
(51 cards)
Traumatic brain injury results in
- bruising and tearing of the brain that produces a loss of consciousness (LOC)
- and/or post-traumatic amnesia (PTA)
The traumatic brain injury can be
- low-energetic trauma (falling from standing height or being struck)
- High-energetic trayma (falling from great height or with great speed)
Clinical presentation is…
heterogeneous, which means that symptoms of the disease vary widely among different patients.
We distinguish different phases
- the acute phase (up to one month)
- the sub-acute phase (1-6 months)
- chronic phase (>6 months)
The severity of the loss of consciousness is determined in..
the acute phase (Glasgow Coma Scale which provides an EMV score)
Traumatic brain injury is present when there is a ….. without any …… and the patient has a …. of the accident
Head trauma
loss of consciousness
Fully conscious memory
The coma can turn into Post traumatic amnesia, what is this?
a transient state characterized by confusion, disorientation, retrograde amnesia and sometimes psychomotor agitation.
What does the duration of post-traumatic amnesia (PTA) indicate?
It indicates the severity of the injury and is more accurate than the EMV score.
When does PTA start and end?
It starts immediately after the injury and ends when the patient can clearly understand and respond to their surroundings.
What memory problem can persist after PTA resolves?
Anterograde memory impairments (AMI), which affect encoding and retrieving new information.
What imaging and assessments are done in the ICU for TBI patients?
CT scans (to detect hemorrhages), EMV score assignment, and pupil reactivity (to assess intracranial pressure).
What state can some survivors of severe TBI end up in?
An unresponsive (or vegetative) state.
Primary brain damage occurs __________ the injury and is caused by __________ forces and excessive release of __________ neurotransmitters.
during; biomechanical; excitatory
Secondary brain damage occurs in the __________ and is due to complications like __________, cerebral oedema, or issues like __________ caused by shock.
hours to days after; hemorrhages; failing cerebral autoregulation
In response to CNS damage, __________ are rapidly activated.
microglia
What’s the difference between primary and secondary brain damage in TBI?
Primary occurs immediately at the time of trauma due to biomechanical forces (e.g., excitatory neurotransmitter release, cell death).
Secondary happens hours to days later due to complications like hemorrhages, edema, or systemic issues (e.g., hypotension, infection).
PTA starts immediately after injury and ends when the patient can _____________.
give a clear answer about their surroundings.
What does linear acceleration-deceleration cause in the brain?
Straight-line forces cause the brain to shift and hit internal skull structures, leading to focal damage like coup injuries.
Where do coup injuries most often occur?
Inferior surface of the frontal and temporal lobes.
What is an epidural hematoma, and what causes it?
It occurs when the meningeal artery is damaged, leading to brain compression. It requires decompression surgery.
What are common complications of linear acceleration-deceleration injury?
Skull fracture, epidural hematoma, subdural hematoma, intracerebral contusions, and traumatic subarachnoid hemorrhage.
What is a contrecoup injury?
Brain damage on the side opposite to the site of impact due to acceleration forces.
What kind of brain damage do rotational forces cause?
Focal-diffuse damage, including tearing of axons and small vessels, leading to traumatic microbleeds and diffuse axonal injury.
Where is diffuse axonal injury (DAI) most likely to occur?
At the gray-white matter junctions, corpus callosum, and brainstem.
