Specific deficits post TBI

Question 1

Post traumatic epilepsy (repeated seizures over time)

Answer 1

occurs in 5-10% of patients with traumatic brain injury, usually within 1 week post injury but may occur much later.

Question 2

Motor deficits:

Answer 2

• Weakness (paresis): maybe in any or all extremities & or trunk
• ataxia or uncoordinated mm movement
• loss of fine and gross motor dexterity
• balance deficits
• change in normal postural reflex mechanisms (righting, equilibrium, protective extension
• dominance of primitive reflexes ( ATNR etc
• Endurance decreased
• Dysarthria: decrease tone oral facial mm
• tonal abnormalities: flaccidity, spasticity
• Abnormal posturing

Question 3

Abnormal Posturing:

Answer 3

~Decorticate rigidity: UE flexion, LE extension: lesion above or in upper brainstem
~Decerebrate rigidity:all 4 limbs in extension (hands flexed) lesion in brain stem WORSE
-generally indicates poorer prognosis than decorticate rigidity

Question 4

Sensory deficits:

Answer 4

Secondary to damage of the central processing areas of the brain: not the organs of sensory perception (eyes, ears)

• Perceptual deficits: neglect, visual field deficits, body scheme
• Visual spatial relationships
• Auditory perception
• Tactile sensations: pain, temperature, touch, stereognosis (perceive form of an object using senses), proprioception and kinesthesia

Question 5

Laguage Deficits:

Answer 5

Broca’s aphasia: unable to express
Wernicke’s aphasia: unable to receive
Global aphasia
may perseverate or ramble

Question 6

Other Language disorders:

Answer 6

dysnomia

• anomia
• dyslexia
• dysgraphia

Question 7

Dysnomia:

Answer 7

Impairment of word finding abilities

Question 8

Anomia:

Answer 8

Total loss of word finding abilities

Question 9

Dyslexia

Answer 9

Difficulty understanding printed material

Question 10

Dysgraphia

Answer 10

Impairment in writing ability (secondary to language deficit not motor deficit)

Question 11

Cognitive deficits: Greatly overshadow physical deficits and cause the greatest handicap in:

Answer 11

• Independent living
• social re-adaption
• family life
• vocational endeavors learning a skill for a trade

Question 12

Cognitive deficit: arousal problems:

Answer 12

Difficulty maintaining degree of alertness

Question 13

Cognitive deficit: Attention deficits:

Answer 13

Lead to inability to filter out irrelevant background stimuli

• Easily distracted- need decrease of environmental stimuli
• need structure to increase performance

Question 14

Learning memory deficits ranges from:

Answer 14

• Misplacing keys to being virtually unable to remember any new info.
• Concept formation & problem solving deficits that often are not evident in casual conversation
• Pt are unable to profit from an experience & often unable to apply old solutions to new situations or unable to generate different solutions for a given problem
• Instead they may persevere in the application of an unworkable solution, leading to repeated failure & frustration

Question 15

Executive Deficits:

Answer 15

• May occur after only a mild head injury with no loss of consciousness
• Pt are unable to execute their plans
• No self-directing & or self -initiating abilities
• have difficulty with task completion unless simple and structured task
• So less evident with structured environment
• Pt are generally unaware of problems & efforts @ self-correction are lacking

Question 16

Psychosocial deficits lead to inappropriate social behaviors a& emotional responses: Secondary to:

Answer 16

-Damage to brain structures that generate & modulate emotionality (limbic system, frontal lobes)
~Limbic system is involved in emotional experience and expression, and can modify the way a person acts. It produces such feelings as fear, anger, pleasure and sorrow.
-Perceptual problems and decreased understanding of environmental cues needed to develop options or conclusions
-Anxiety and depression

Question 17

Signs:

Answer 17

• Disorientation
• agitation, violence, impatience
• delirium: sudden severe confusion
• hallucination
• unpredictable, bizarre, impulsive behavior
• childlike dependence
• emotion lability
• sexual disinhibition: inappropriate comments or gestures
• sex drive increases or decreases