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12 Cards in this Set
- Front
- Back
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define: diffuse axonal injury
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rotational shear stress - when your brain keeps going forward with car jolting backward and then body (example of closed mechanism of TBI)
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what are the most common areas of the brain to be injured during a TBI?
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frontal lobe, temporal lobes
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what are the top most common causes of TBI?
what is the #1 cause in elderly ppl? |
motor vehicle accidnets(50%)
falls(21%) assaults(12%) sports(10%) in elderly - #1 is falls |
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most common complaint from family members of pts who have TBIs
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short temper, anger
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What are history taking questions for a possible TBI pt? Remember that history is the most important thing in these cases!!
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Have you ever hit your head? Been in an accident?
Did you black out, pass out, or lose consciousness? What is the last thing you remember before the injury? What is the first thing you recall after the injury? (If no LOC) At the time of the injury, did you experience any change in your thinking or feel “dazed” or “confused”? What problems did you have after the injury? Has anyone told you that you’re different since the injury? If so, how have you changed? Did anyone witness or observe your injury? Have you had any other injuries to your head or brain? Many people who have injured their head had been drinking or using drugs; how about you? |
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T or F. you have poorer prognosis for a TBI if you have been drinking alcohol prior to accident.
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T.
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what is the "gold standard" assessment for measuring severity and estimating prognosis for TBI pt?
what are some other ways to classify TBIs |
Glasgow Coma scale (GCS) - eye opening, motor response, verbal response ==> coma score
other ways to classify (based on duration): - LOC (loss of consciousness) - PTA (post-traumatic amnesia) |
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what are the 4 components of neuropsychiatric assessment to make a Dx for TBI?
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1. cognitive (LOC, processsing speed, executive function, most common problem is with attn/concentration)
2. emotional (mood swings, depression, hypomania/mania, anxiety, anger) 3. behavioral (esp if orbitofrontal portion is scraped - could lead to impulsivity, lack of self control and anger management; change in personality) 4. physical (fatigue, weight cahnge, sleep disturbance, headache, etc) |
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what are some "bedside" evaluative tests for frontal lobe fxn?
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clock-drawing
Verbal fluency - name all the words you can that start with an “A” in 60 seconds Set shifts/sequencing - selective attn - “1a, 2b, 3__?” "fist-side-palm" test |
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what is the best way to map damage in the brain during a work-up
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neuropsychological testing
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most common cause of dementia in young ppl
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TBI!!!
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there are lots of psychiatric Dx due to TBI. ANYTHING is possible. so name some....
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-cognitive disorder NOS (headache, dec attn/conc, dec short-term memory, emotional lability, tinnitus)
- personality change (apathetic, disinhibited, aggressive, labile, paranoid) - mood disorder, depressed or manic - anxiety/sleep disorder |
