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12 Cards in this Set
- Front
- Back
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neocortical necrosis
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in cases where there is extensive neocortical necrosis, the cause is not so much the severity of the injury, but a consequence of resuscitation following cardio-respiratory arrest
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subcortical white matter
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in cases where there is extensive subcortical white matter shearing, the cause is the severity of the initial impact damage.
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focal injuries
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such as contusions, or hematomas will often leave residual focal neurological deficits such as hemiplegia,hemiparesis, hemianopsia, aphasia
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cranial nerves
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CN abnormalities often arise when CN's are damaged when the skull is fractured or when the brain is thrown about during acceleration/deceleration injury
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Post-traumatic seizures (PTS):
factors which raise the probability of developing PTS |
-there is a definite risk of developing a chronic, recurring seizure disorder after significant head trauma
-factors which increase that risk are: 1. depressed fracture w/ dural tear(>50%) 2. penetrating wounds (>50%) 3. amnesia of > than 24 hours 4. time after injury that first seizure occurs: a. immediate (little chance of becoming chronic) b. 1st week (33%) c. 1st -8th week (70%0 |
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PTS
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-seizures can 1st appear many yrs after an accident
-they are usually focal and more difficult to treat than idiopathic epilepsy -PTS is a chronic disorder w/ only a 40% cure rate after 5 yrs -PTS is the most common and probably most complex sequelae of HI -the basic elements of the syndromes are headache, dizziness, difficulty concentrating, and a host of vague behavioral symptoms such as anxiety, depression, and nervous instability |
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PTS exacerbations
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-this syndrome is more common w/ slight trauma than serious
-the syndrome usually lasts a few weeks to a few months, w/ symptoms gradually disappearing only to be exacerbated by strenous physical activity, emotional stress, or the use of alcohol -pts in highly physical or stressful jobs should be warned that symptoms might recur when they return to work -rest and symptomatic trtmt are usually required |
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Seizure disorders
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-some people develop seizures after a head injury. These are not part of the demntia, but they can complicate dx and trtmt of dementia
-20% of symptomatic epilepsy in the general population is caused by TBI |
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Epileptic seizures
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-clinical manifestation resulting from abnormal and excessive discharge of a set of neurons in the brain
-epilepsy is a condition characterized by 2 or more recurrent epileptic seizures, unprovoked by an immediate cause |
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PTE vs PTS
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PTE= a disorder characterized by recurrent late seizure episodes in pts w/ TBI
PTS= refer to either a single or recurrent seizure episode (epilepsy is not used in TBI cases as most research does not address recurrence of seizures) -main difference is PTS only has to be one |
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PTS logistics
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-early <1 wk after TBI
-late >1 wk after TBI Onset -1/2 to 2/3 of TBI pts will develop PTS w/in the 1st yr, 75-80% w/in 2 yrs |
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What causes PTS in TBI?
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-hydrocephalus (build up of CSF causing pressure on the brain)
-sepsis (whole body poisoning) -hypoxia (lack of O2) -lesions -hemorrhages -medications- tricyclic antidepressants and some SSRI's -illicit drugs - cocaine (x3 levels of firing) -high doses of caffeine |
