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TRAUMATIC BRAIN INJURIES (TBI) - Coggle Diagram
TRAUMATIC BRAIN INJURIES
(TBI)
Definition
Alteration in brain function due to external force
Blunt / penetrating head injury
Results
Loss of consciousness (LOC)
Post-traumatic amnesia (PTA)
Skull fracture
Neurological findings
Types of damage
Focal (direct blow, coup/contrecoup, sharp/blunt trauma)
Multifocal/Diffuse (contusion, diffuse axonal injury, hemorrhage)
Severity: Mild / Moderate / Severe
Closed vs Open (penetrating) injury
Etiology
Traumatic causes
Falls (elderly >65 years)
Motor vehicle accidents (15–40 years)
Sports injuries (5–24 years)
Assault / child abuse (infants, young children)
Explosive blasts (military)
Non-traumatic causes
Stroke, Tumor, Brain abscess
Anoxia (cardiac arrest, drowning)
Infections (meningitis, encephalitis)
Toxins (CO poisoning, substance abuse, overdose)
Degenerative disease, dementia, epilepsy
Pathophysiology
Closed injury
Coup (point of impact)
Contrecoup (opposite side)
Diffuse axonal injury (shearing/tearing of axons)
Bleeding
Epidural
Subdural
Subarachnoid
Intracerebral hemorrhage
Secondary effects
Hypoxia
Swelling
Increased ICP
Hydrocephalus
Clinical Features
Physical: Ataxia, rigidity, limited ROM, primitive reflexes, postural deficits
Cognitive: Confusion, memory loss, poor judgment, slow thinking
Psychosocial: Aggression, depression, personality changes
Visual: Blurred vision, diplopia, visual field loss
Perceptual: Neglect, spatial disorientation, agnosia
Level of Consciousness
Glasgow Coma Scale (GCS) → Eye, Verbal, Motor response
Rancho Los Amigos Scale (RLAS) → Levels I–VIII
Post Traumatic Amnesia Scale (PTAS) → Duration of amnesia = outcome predictor
Diagnosis & Management
Diagnosis
GCS
CT / MRI
Clinical exam
Medical management
ICP control
Medications
Ventilation
Surgical management
Craniotomy (hematoma removal, ICP relief)
Decompressive craniectomy
VP Shunt (hydrocephalus)
Cranioplasty (reconstruction)
Complications & Prognosis
Complications
Hypoxia
Raised ICP
Hydrocephalus
Seizures
Infection
Prognosis
Depends on severity, duration of LOC/PTA, age, comorbidities
Long PTA (>4 weeks) → long-term disability
Mild TBI → usually good recovery