TBI Statistics
What is the leading cause of TBI?
Falls (40%, 2006-2010)
What is a TBI?
A craniocerebral injury from an external mechaniccal force in the form of a bump, blow, or jolt to the head. Causes temporary or permanent brain function impairment
What is the general prognosis for comas? For example:
Severe disability "unlikely" with a coma what length?
Positive recovery "unlikely" with a coma of what length?
Severe disability "unlikely" with a coma <2 weeks
Positive recovery "unlikely" with a coma of >4 weeks
There are several factors related to one's ability to attain pre-injury status. What are three factors?
Support system
Personality
Severity of TBI
Pre-injury abilities
What is the scope of practice for the SLP when treating TBI?
Treatment of cognitive processes as they relate to communicative behavior and language
T/F: TBI survivors experience many years' worth of lasting effects (long-term consequences) only.
False! Survivors can experience effects over a short duration of time as well (several days)
Name three symptoms of TBI.
Altered consciousness
Amnesia
Skull fractures
Intracranial lesions
Death
T/F: When compared to less-dependent patients, more dependent patients make more progress and also remain more dependent at discharge.
True!
What is a coma?
State of unconsciousness, eyes closed, patient does not wake (brainstem, thalamic implications)
Name two forms of standardized assessment for individuals with TBI.
WAB
Behavior Rating Inventory of Executive Function
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What is the name for TBI injuries sustained by military elements including grenades, gunshots etc?
Blast injuries
Name three types of disruption that older adolescents and young adult males experience with TBI.
Educational disruptions
Vocational disruptions
Social disruptions
Cognitive impairments may affect several areas. What are three of them?
Orientation (frontal lobe)
Communication (frontal lobe, language areas)
Attention/concentration (thalamo-frontal pathways)
Memory (hippocampal, thalamic, frontal)
Executive functioning (prefrontal cortex, cortical-subcortical pathways)
Anosognosia
Behavioral (orbitofrontal cortex, amygdala)
Name a form of non-standardized assessment for individuals with TBI.
Discourse analysis (monologue or conversational)
Name two other causes of TBI.
Assault
Unintentional blunt trauma
Name two TBI severity scales.
Glasgow Coma Scale (15-point scale based on eye opening verbal responses, and motor responses)
Abbreviated Injury Scale (ranking injuries from minor --> unsurvivable, estimates threat to life)
Name two factors of a TBI that are associated with a poorer prognosis/outcome.
Depth of lesion (deeper = poorer outcome)
Lower GCS score = poorer outcome
Coma greater than 4 weeks in length = poorer outcome
Age (65+ = poorer outcome)
When someone is unaware that a disorder/impairment is present
Name two forms of treatment for individuals with TBI.
Attention training
Use of external memory aids
Executive function training
TBIs are the cause of what percentage of injury related deaths (2010)?
30%
Give one example of primary injury damage and one example of secondary/post-injury damage with TBI.
Primary injury damage: Cortical effects, axonal injury, vascular injury
Secondary injury damage: Ischemia, edema, further axonal injury
After entering emergency medical care, TBI patients will hopefully then be discharged to one of three settings. What are they?
Inpatient rehab (still at the hospital)
Subacute care/subacute rehab
Home
What are the three cognitive impairments resulting from TBI that have frontal lobe implications?
Orientation
Communication
Memory
Explain why we need to practice caution when using standardized assessments of individuals with TBI.
It's very context-based; goals and tools needed will change depending on the stage of rehabilitation of the individual. Lots of factors need to be considered in order to have accurate context (premorbid factors, stage of recovery, personality, etc.)