Scribd Logo
Upload

Welcome to Scribd!

  • Traumatic Brain Injury

    Uploaded by

    Julia Salvio
    41 views2 pages
    Traumatic brain injury is caused by an external force that alters brain function and structure, with the most common causes being falls, motor vehicle accidents, and assaults. Diffuse axonal injury, characterized by shearing of axons, is a primary injury that can lead to secondary injury involving biochemical and cellular changes over 24-48 hours. Treatment involves managing secondary injuries like increased intracranial pressure and edema, while physical therapy focuses on improving arousal, cognition, motor function, and independence with activities of daily living.

    Original Description:

    TRAUMATIC BRAIN INJURY

    Original Title

    15.-TBI

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Traumatic brain injury is caused by an external force that alters brain function and structure, with the most common causes being falls, motor vehicle accidents, and assaults. Diffuse axonal injury, characterized by shearing of axons, is a primary injury that can lead to secondary injury involving biochemical and cellular changes over 24-48 hours. Treatment involves managing secondary injuries like increased intracranial pressure and edema, while physical therapy focuses on improving arousal, cognition, motor function, and independence with activities of daily living.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    41 views2 pages

    Traumatic Brain Injury

    Uploaded by

    Julia Salvio
    Traumatic brain injury is caused by an external force that alters brain function and structure, with the most common causes being falls, motor vehicle accidents, and assaults. Diffuse axonal injury, characterized by shearing of axons, is a primary injury that can lead to secondary injury involving biochemical and cellular changes over 24-48 hours. Treatment involves managing secondary injuries like increased intracranial pressure and edema, while physical therapy focuses on improving arousal, cognition, motor function, and independence with activities of daily living.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 2

    DAI is the predominant Tonsillar – tonsils of

    Traumatic Brain o
    MOI in individuals c
    o
    cerebellum  foramen
    Injury severe to moderate TBI
    and m/c cause of
    magnum
    o Uncal/Tentorial – occurs
     Alteration of brain immediate loss of in the tentorium cerebelli
    function/other evidence of brain consciousness o Central – central part of
    pathology caused by an o Shear forces  diffuse brain herniates 
    external force axonal injury  Wallerian brainstem
    Prevalence degeneration  NT o Subfalcine – Into the falx
     Falls (32%) release  Glutamate cerebri
     MVA/traffic accidents (19%) toxicity (facilitates liquid Impairments – more diffused than CVA
     Struck by/against events (18%) eme in the brain)  Neuromuscular
     Assaults (10%) – GSW, violence  DAI o Paresis
     M/c in 0-4 y/o o Common in the o Abnormal tone
     Death and hospitalization parasagittal white matter o Motor function
    common in 65 y/o and above of the cerebral cortex o Postural control
    MOI and Pathophysiology (m/c), corpus callosum,  Decorticate –
    Primary Injury pontine-mesencephalic denotes severe TBI
     Direct trauma to parenchyma junction adjacent to sup  Decerebrate –
    o Shaken Baby Syndrome cerebellar peduncles more severe TBI,
    o Results in contusions, o Common in high-speed all limbs are
    lacerations, and MVAs and sports-related extended
    intracerebral hematomas, TBI  Cognitive
    can be seen in CT and o Acceleration/deceleration o Arousal level – measured
    MRI scans cause disruption of c GCS
    o Generally focal neurofilaments c/in the  13-15 –
     Ant temporal poles axon  Wallerian mild/concussion
     Frontal poles degeneration  9-12 - moderate
     Lat and inf Secondary Injury – c/in 24-48 hrs  8 and below –
    temporal cortices  Cascade of biochemical, comatose (Does
     Rapid acceleration/deceleration cellular, and molecular events not open eyes,
    of the brain that evolve over time does not make
    o Shear, tensile,  Injury-related hypoxia, edema, sound, does not
    compression forces in the ↑ ICP follow command)
    brain  (N) ICP: 5-20 cm H2O
    o Results in Diffuse Axonal  ↑ ICP  herniation of brain
    Injury (tissue tearing of
    the axons), microscopic
    traumat day <7 days  Disorders of
    ic days Consciousness
    amnesi Scale (DOCS)
    a  Ranchos Los
    GCS 13-15 9-12 8 and Amigos Level of
    below Cognitive
    Imagin Norma Normal Normal Functioning – pt
    g l or or may plateau at any
    abnorm abnorm
    level
    al al
     Box 19.4
    PTA evaluation - Galveston Orientation  Moderate-Severe, Active Stage
    and Amnesia Test (GOAT) o Box 19.5
     >48.5 have higher o Outcome Measures
     >34 days – good overall  Berg’s Balance
    recovery as per GOS Scale
    o Plan of Care
     >27 days likely to be employed
     Risk of secondary
     >53 days likely to live s
    impairment is
    assistance
    o Attention reduced
    PT Management
    o Concentration
     Moderate-Severe, Acute
    o Memory
    o Examine pt
    o Learning
     Arousal - GCS,
    o Executive Functions
    attention, cognition
     Neurobehavioral  Integument
    o Agitation/Aggression integrity
    o Disinhibition  Sensory integrity
    o Apathy  Motor function
    o Emotional lability  ROM
    o Mental inflexibility  Reflex integrity
    Mild Modera Severe  Ventilation and
    te respiration/gas
    LOC 0-30 >30 >24 hr exchange
    min min - o Outcome measures
    <24 hr  Coma Recovery
    AOC Brief >24 hr >24 hr Scale-Revised
     24
    (CRS-R) –
    hr
    evaluated once/wk
    Post- 0-1 >1 and >7

    You might also like