RLA & GCS
What is the lowest score you can obtain and be pronounced dead?
3
Minimally consciousness is RLA __-__
1-2
Selective attention; self regulation; self monitoring; inhibition are part of which section of the prefrontal cortex?
Attentional control
Initial GCS; age; race; education level; previous TBI; work history; petechial hemorrhage; subdural hematoma; midline shift; subarachnoid bleed; obliterated 3rd ventricle; basal cistern; duration of PTA
Factors impacting prognosis for recovery
Disability related to early damage of the brain areas that control motor function; primarily motor (weakness, poor motor recruitment, poor balance, poor integration of proprioception/vision/vestibular), possible intellectual impairment; acquired CNS disorder; stroke in utero, at birth, or up to a year of age; UMN lesion
Cerebral palsy
Range for Glasgow coma scale
3-15
"The cognitive skills involving planning, manipulating information, self monitoring, problem solving and abstract thinking"
Executive functions
Initiative; conceptual reasoning; planning; strategic organization are all part of which section of the prefrontal cortex?
Goal setting
Collection of fluid in most inferior aspect of the cranium causing some issues with blood flow and CSF flow causing pressure on brainstem
Basal cistern
T/F: Children with cerebral palsy can be either diplegic or quadriplegic ?
Concussion (mild TBI) is RLA ___-___
8-10
RLA levels for executive functions
6 and above
Efficiency; fluency; speed of processing are all part of which section of the prefrontal cortex?
Information processing
Soccer players hitting head repeatedly with the ball; lose verbal filter, physically and verbally violent, physical aspects come later; incidences and causes unclear; multiple concussive events; progressive degenerative disease; cognitive and behavioral changes
Chronic traumatic encephalopathy (CTE)
Rapid onset, short lived; HA, disorientation, dizziness, nausea, irritable, distractible; usually resolve in 7-10 days; increased recovery time could be LOC > 1 min, cognitive symptoms, young, female, depression
Concussion
Moderate TBI is RLA _-_
5-7
Prefrontal cortex does 4 things..
1. cognitive flexibility
2. attentional control
3. goal setting
4. information processing
How does age impact prognosis for recovery of a TBI?
The older you are, the worse the outcome
Children under 10 have worse prognosis because they are not mature enough to motor program
Second concussion occurred before the first one resolved completely; severity of second concussion can be catastrophic because the brain has not healed yet; catastrophic reaction to a second concussion; rapid progression to severe disability or death if not addressed immediately
Second impact syndrome
T/F: Cerebral palsy is an acquired CNS disorder?
True
Severe TBI is RLA __-__
2-5
Divided attention; working memory; conceptual transfer; feedback utilization are part of which section of the prefrontal cortex
Cognitive flexibility
Which race has a poor prognosis for recovery from TBI?
African Americans/Hispanic
Other systems involved with brain injury
GI; musculoskeletal; genitourinary; integumentary; respiratory