traumatic brain injury 2
Terms
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- Open head injury
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Penetrating
surgical intervention:
reduce swelling
remove bone fragments
relieve pressure
Something has entered head and swelling resumts (projectile, knife, etc.)
causes diffuse injury
diffuse goes away- problem more generalized
brain is shaken
prognosis varies= less severe in long run because injury is localized
faster functioning returns
the more likely to see impact later
imporvement past one year doesn't really exist
connectionism- everything is connected
no regeneration or regrowth of brain tissue - hydrocephalus
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water on brain
spinal fluid builds up in brain
happens in open head injuries - connectionism
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different tissue of brain connected to different skills
damaged area is related to area that's injured
focal deficits
happens in open head injuries - plasticity
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ability to transfer functions from a damaged area to another
works better in younger brain
happens in open head injuries - closed head injury
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Blunt head injury
3 layers of tissue line brain between skull- shock absorbers
if layers get overwhelmed brain sloshes up against inner layer of skull
3 neuropathologies:
1. force of impact injuries
2. shearing injuries
3. secondary damage - 3 major types of closed head injuries
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1. force of impact injuries
2. shearing injuries
3. secondary damage - Force of impact injuries
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static injury- sitting still and something hits the head
coup- place where impact occurs first
brain forced forward and bounces to back side
contra coup- place where brain hits opposite side of skull
may be more severe than coup damage - deficits
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aphasia: language
hemiparesis: loss of motor functioning in half of body
hemionopsia: without half of vision
memory decreased
processing speed decreased - coup
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place where impact occurs first
brain forced forward and bounces to back side - contracoup
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place where brain hits opposite side of skull
may be more severe than coup damage - Causes dur to ischemia in brain during TBA
- reduction in ability to remove waste products of brain, leaving build up of toxins
- Shearing injuries
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combination of transitory (movement) and rotational acceleration
brain is moving and suddenly comes to a stop
brain hits front of skull and hits projections in skull causing rips in layer, then brain moves down causing tearing
impact injury as well
when head in motion (car acident, shaken baby syndrome) - secondary damage
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physiological process that develops after trauma
bleeds collect (hematoma)
swelling
build up of cerebral spinal fluid
build up of toxins
major causes of deaths in brain injury - RAS
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reticular activating system
part of hind brain that keeps you alert or allows sleep
in a concussion- loss of consciousness from any impact is affecting RAS
returns to consciousness but not necessarily normal functioning - concussion
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loss of consciousness resulting from impact hitting RAS
(raticular activitating system)...keeps brain awake - coma
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concussion with long term loss of consciousness
can't be roused by noxious stimuli
prognosis for open head injury- length of time in coma - contusion
- bruise on brain
- post concussion syndrome
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residual affects, very small differences
subtle changes in functioning occurs - TBI & Types
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traumatic brain injury
15-20 year old males
Types:
1. open head injury (penetrating)
2. closed head injury (blunt) - Profile of TBI individual
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aphasia: language deficits
visual perception deficits
hemiperesis
hemionopsia
sensory losses
memory affected
speed of processing decreased
multitasking processing decreased - temporal lobes
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hearing
language comprehension
Broca/Wernicke's area
receptive/expressive language - parietal lobes
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tactile senses
visual, processing and integration of sensory information - occipital lobes
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visual information
back of head
reading - frontal lobes
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executive functioning- brings rest together
origin of motor neurons
organizer (thoughts and plans)
motor ability
personality
intellectual integration
moderation, modulation of emotions
most frequent damage along with temporal
higher order functioning
judgment, abstract thinking - confabulation
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making up stories
unconsciously
pathological, not intentional
gaps in memory - post traumatic amnesia
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shorter memory problems
cannot learn new things from time of injury on
remembers past
blanket loss of all new memory - retrograde amnesia
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person doesn't remember accident or anything minutes or hours before
part of short term memory loss of of minutes to days prior to trauma - agnosia
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loss of ability to recognize certain stimuli
without sensory input, tactile, auditory, visual, gustatory, oral, idealization - long term memory deficit
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memory for a few minutes or hours only
cannot put it into long term memory to make it permanent - Rehabilitation of Blunt Head injury
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utilize people who are close and can monitor
no psychotherapy
Individual feels:
denial
feel like held hostage
sensitivity to noise
sensitivity to light
fatigue
may utilize:
diary so not to forget things
calendar
computer games: structure, interesting, focus attention, stimulating - CAT/CT Scan
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Diagnostic procedure
computerized axial tomography
axial: rotating
tomography: study of layers- 3D picture
not 100% accurate
sees abnormality OR deficit- not both - PET Scan
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positron emission tomography
radioactive subinjected into body
dead spots do not absorb so shows problem areas
better than CAT scan - EEG
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electro encephalogram
measures brain activity
picks up live brain cells
better for finding seizures - MRI
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Magnetic Resonance Imaging
(used to be called- Nucleur Magnetic Resonance)
most popular and best
most effective way of discovering TBI
mesures presence of radio waves that live tissue gives off - simultaneous processing
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multi-tasks at the same time
difficulty for individuals who have TBI - general functioning/time
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impair ability to think things out
time may be elongated - regression of the brain
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brain more reactive than sophisticated
manifested in frequent naps
regresses to childhood, infancy
spontaneous