Traumatic Brain Injury

Posted by e-Medical PPT
Traumatic Brain Injury (TBI) Definition: A nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairments of cognitive, physical, and psychosocial functions with an associated diminished or altered state of consciousness.

Mechanism of Injury
MVAs are the leading cause of TBI in the United States and account for approximately 50% of all TBIs. These include automobiles, motorcycles, bicycles and pedestrian struck.  MVAs are also the leading cause of TBIs in individuals under the age of 75.

Falls are the 2nd leading cause of TBI, accounting for 20-30% of all TBIs. In individuals aged 75 years and older, falls are the most common cause of TBI.

Firearms are the 3rd leading cause of TBI (12% of all TBIs).

Sports, Recreation, Physical Violence (eg. child abuse)

Alcohol is a major factor in many TBIs and often is associated with the leading causes of TBI.

Classification
Closed Head Injury: Occurs when the head forcefully collides with another object (for example the windshield of a car) but doesn't fracture or penetrate the skull.

Open Head Injury: Occurs when an object (for example a bullet) fractures the skull and debris enter the brain.

Focal: Confined to one area of the brain. 
Diffuse: Involving more than one area of the brain.

Focal injury
Associated with:
Contusion: bruising of brain
Intracranial hemorrhage (hematoma): heavy bleeding in the skull. Hemorrhage, due to rupture of a blood vessel in the head, can be extra-axial, meaning it occurs within the skull but outside of the brain, or intra-axial, occurring within the brain.
Extra-axial hemorrhages: subdural hematoma, epidural hematoma, and subarachnoid hemorrhage.
Intra-axial bleeds: intraparenchymal hemorrhage which occurs within the brain tissue itself and intraventricular hemorrhage which occurs into the ventricular system.

Diffuse 
Associated with:
Concussion: a shaking of the brain in response to sudden motion of the head
Diffuse axonal injury (DAI): extensive generalized damage to the white matter tracts of the brain and a major cause of unconsciousness after head trauma. 90% of patients with severe DAI never regain consciousness.
Coma: profound state of unconsciousness...

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