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19 Cards in this Set
- Front
- Back
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TBI
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Unique: Acquired, Diffuse Brain Injury
May be penetrating or non-penetrating Ranges from “post-concussional” aka MTBI (mild) to severe disability “...localized and diffuse brain injury associated with acceleration/deceleration of the brain” |
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#1 cause of TBI
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Falls (29%)
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Other causes
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Motor Vehicle Accidents (20%)
Violence: assaults, domestic abuse, gunshot wounds (GSW: 90% lead to death) Recreation/Sports (children/young adults) Shaken Baby Syndrome (death) Blasts: leading cause in active duty military personnel in war zones |
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Blast Injuries
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Different type of brain injury
-Result of a complex pressure wave -Affects organs filled with air (ear, lungs) as well as fluid-filled cavities (brain, spine) -Debris or bodily injury from being thrown ->10% of soldiers returning to US from Iraq/Afghanistan have evidence of TBI |
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Who's affected?
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under 35 years old
Males more likely |
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Facts
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1.4 mill sustain TBI
5.3 americans currently with disability from TBI |
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Primary injury to brain
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Primary—occurs at the time of the injury,
related to mechanical forces, results in coma --Diffuse Axonal Injury -- Focal contusions and other acute path‟s -- Penetrating (or not) -- Coup-Contra Coup --Hypoxia/Ischemia |
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Secondary brain injury
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Occurs hours/days after the injury
Mass effect of shifting of the brain structures Hydrocephalus (increase in CSF causing increased intracranial pressure) *** Infection Hematomas (pooling of the blood/clots) Auto destructive cellular phenomenon |
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Coma
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Hallmark of severe brain injury: unconscious
Length of coma is correlated with outcome Typical and predictable course of recovery (stages of recovery) Nevertheless—individual process |
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Diffuse Damage
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Alertness/arousal reductions
Attentional disorders Acute period after accident: period of retrograde amnesia, anterograde amnesia, Memory problems: orientation, working memory, recent events, new learning of facts, and recall of procedures |
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Comm Probs TBI
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Correlated with site of brain injury
-focal lesion R/L hemisphere -frontal lobe -brain stem, location of cranial nerves |
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Sph and hearing disorders
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dysphagia
hearing structural damage to sph mechanism motor sph disorders- dysarthria lang disorders- aphasia pragmatic/prosodic disorders |
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Cognitive deficits
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Info processing
problem solving/judgment abstract reasoning executive functioning |
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Brain injury related bahaviors
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impulsivity, ego-centricity, concreteness, low mental endurance, agitation, irritability, confabulation, distractibility, verbosity, emotional, low frustration tolerance, reduced insight, perseveration
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Philosophies of rehabilitation
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1. Restorative approach (therapeutic focus) to regain skills
2. Compensatory approach- memory strategies, learning strategies |
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Cognitive comm therapy
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RLA level III "localized level" coma
RLA level IV: confused, agitated response, treatment aimed at attention span, basic info processing |
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Rancho level VII
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confused, appropriate response level
focus on prob solving, judgment, daily activities Stimulus: what could happen if... Use of calendars, routines |
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Holistic approach
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treat the whole person
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Role of SLP
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Significant role in the recovery process, in terms of
education and advocacy “Agents of neuroplasticity”-changes in brain functioning due to therapy Gonzales-Rothi Reduce the long terms consequences with appropriate cognitive rehabilitation Audiologists play a significant role in the assessment, and sometimes the rehab process as well |
