slide I INTRODUCTORY REMARKS ON TBI

Definition

"Traumatic brain injury (TBI) is a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness. "

MEASUREMENTS OF TBI EFFECTS

1.Glasgow Coma Scale

2.Ranchos Los Amigos Scale of Cognitive Functioning

3TBI defined by the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine

 

Dawodu et al.

• Any period of loss of consciousness (LOC),
• Any loss of memory for events immediately before or after the accident,
• Any alteration in mental state at the time of the accident,
• Focal neurologic deficits, which may or may not be transient."
  1.74 million persons sustain mild TBI requiring an office visit or temporary disability for at least 1 day.  2.5-6.5 million Americans live with TBI-related disabilities.Costing 4-10 billions a year to the american Economy based of various estimates!
   Approximately 52,000 US deaths per year result from TBI.
  
  

Glasgow Coma Scale

The Glasgow Coma Scale (GCS) defines the severity of a TBI within 48 hours of injury.

Eye opening

• Spontaneous = 4
• To speech = 3
• To painful stimulation = 2
• No response = 1

Motor response

• Follows commands = 6
• Makes localizing movements to pain = 5
• Makes withdrawal movements to pain = 4
• Flexor (decorticate) posturing to pain = 3
• Extensor (decerebrate) posturing to pain = 2
• No response = 1

Verbal response

• Oriented to person, place, and date = 5
• Converses but is disoriented = 4
• Says inappropriate words = 3
• Says incomprehensible sounds = 2
• No response = 1

The severity of TBI according to the GCS score (within 48 h) is as follows:

• Severe TBI = 3-8
• Moderate TBI = 9-12
• Mild TBI = 13-15