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TBI (Traumatic Brain Injury)

TBI (Traumatic Brain Injury). Amara, Andrew, Elise, Jonathan, McKenzie. Traumatic Brain Injury. Sue has suffered a Traumatic Brain Injury What are her symptoms? What are some physical and emotional problems that she is dealing with? Why does she not know what is wrong with her?

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TBI (Traumatic Brain Injury)

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  1. TBI(Traumatic Brain Injury) Amara, Andrew, Elise, Jonathan, McKenzie

  2. Traumatic Brain Injury Sue has suffered a Traumatic Brain Injury • What are her symptoms? • What are some physical and emotional problems that she is dealing with? • Why does she not know what is wrong with her? • How might she be helped?

  3. Definition  Injury to the brain (not including conditions present at birth, birth  trauma, or degenerative diseases or conditions) resulting in total or partial disability or psychological maladjustment that affects educational performance; may affect:  • cognition • language  • memory  • attention  • reasoning  • abstract thinking  • judgment • problem solving  • sensory or psychosocial behavior  • physical functions • information processing  • or speech

  4. Definition • There is injury to the brain caused by external force. • The injury is not caused by a degenerative or congenital condition. • There is a diminished or altered sate of consciousness. • Neurological or neurobehavioral dysfunction results from the injury.

  5. Two varieties of TBI • Open head injury - penetration of the headCommon causes:severe fall, gunshot, assault, vehicle accident, surgery • Closed head injury - no open head wound; brain damaged internallyCommon causes:Falls, vehicle accidents, sports accidents

  6. Focal Injury - Injury is highly concentrated in a particular area Usually from open head injury and/or brain penetration Symptoms closely related to functions governed by affected area of brain. Easier to detect using medical imaging technology Diffuse - Injury is not pinpointable Usually from closed head sudden rotational deceleration. (e.g. Head hitting the airbag)  Symptoms may not be evident, since location of injury is unknown. Almost impossible to detect Two varieties of Injury

  7. We are now entering the brain...

  8. The brain contains billions of Neurons They connected to other neurons by dendrites and axons. Dendrites receive - Axons send signals

  9. An AxonNeurological signals travel through the axon.

  10. Diffuse Axonal Shearing Axon is twisted or severed Communication between neurons is inhibited.

  11. Diffuse Axonal Shearing http://www.youtube.com/watch?v=AmAML1-F2LE What are some factors that can make this injury difficult to detect? What do you think the impact might be on brain function as a whole?

  12. Causes • Accidental Falls • Vehicular accidents • Child Abuse • Assaults, Gunshots • Violent shaking of a child • Sports related injuries • Football • Hockey • Recent rule changes in the NFL • old way of dealing with concussion symptoms vs. the new way http://www.nytimes.com/info/concussions-in-football/

  13. Symptoms •    varies from mild to profound •    may be permanent or temporary •    symptoms may appear immediately or over weeks, months, years

  14. Primary Brain Damage Damage that is complete at the time of impact may include: • Skull fracture: breaking of the bony skull • Contusions/bruises: often occur right under the location of impact or at points where the force of the blow has driven the brain against the bony ridges inside the skull • Hematomas/blood clots: occur between the skull and the brain or inside the brain itself • Lacerations: tearing of the frontal (front) and temporal (on the side) lobes or blood vessels of the brain (the force of the blow causes the brain to rotate across the hard ridges of the skull, causing the tears) • Nerve damage (diffuse axonal injury): arises from a cutting, or shearing, force from the blow that damages nerve cells in the brain's connecting nerve fibers      http://www.asha.org/public/speech/disorders/TBI.htm

  15. Secondary Brain Damage Damage that evolves over time after the trauma may include: • brain swelling (edema) • increased pressure inside of the skull (intracranial pressure) • epilepsy • intracranial infection • fever • hematoma - internal bleeding • low or high blood pressure • low sodium • anemia • too much or too little carbon dioxide • abnormal blood coagulation • cardiac changes • lung changes • nutritional changes                          http://www.asha.org/public/speech/disorders/TBI.htm

  16. Taboo Activity Extra Challenge!!!

  17. Characteristics • Problems remembering things • Problems learning new information • Speech and/or language problems • Difficulty sequencing things • Difficulty in processing information (making sense of things) • Extremely uneven progress (quick gains sometimes, no gains other times) • Inappropriate manners and mannerisms • Failure to understand humor or social situations • Becoming easily tired, frustrated, or angered • Unreasonable fear or anxiety • Irritability • Sudden, exaggerated swings of mood • Depression • Aggression • Perseveration (persistent repetition of one thought or behavior)

  18. Long Term Effects • Alzheimer's Disease: recent research suggests correlation between head injury in early adulthood and AD later in life • Parkinson's Disease: rare, but may occur • Dementia Pugilistica: also known as chronic traumatic encephalopathy, usually acquired from repetitive blows to the head (boxers)  • Post-traumatic Dementia: long term memory problems, caused by single, severe traumatic brain injury resulting in a coma                         http://www.braininjurydisorders.org/tbi_8.html

  19. Living with TBI & Rehabilitation http://www.youtube.com/watch?v=4m1ULS9K_4w&feature=related http://www.youtube.com/watch?v=FgtHvBF4t-E&feature=related

  20. Rehabilitation A person with a traumatic brain injury must be observed very frequently during the first weeks following injury because: • Symptoms can be most severe early on, •  Newly injured brain often swells due to bruising, • Symptoms can go away as brain heals, depending on severity of injury, •  Swelling of the brain after injury can put pressure on the brainstem, possibly leading to coma, •  Some symptoms may be permanent and others temporary Because of this variability, definitive diagnoses cannot be made immediately following injury and medical attention is crucial.

  21. Rehabilitation 2 Goals • Restore function of previous ability • Learning coping strategies for irretrievable abilities. • Strengths and weaknesses in attention, memory and ability to speak/understand language must be analyzed by team of specialists to determine course of treatment

  22. Rehabilitation: Team of Specialists Speech-Language Pathologist - specializes in production of verbal communication. Neuropsychologist - determines to what degree and how the brain is involved in difficulties. Occupational Therapist - specializes in structuring day to day tasks. Physical Therapists - specializes in physical functions, balance and movement.

  23. Rehabilitation Therapy begins with development of: • Gross motor skills, perception, attention and focus.  THEN 2. Fine motor skills and intellectual skills.

  24. Cognitive Therapy Two types of functionality focused on during therapy • Cognitive Function - Knowledge of facts and procedures   2. Executive Function - Awareness of self and others, problem solving/judgment ability, social skills.

  25. Other Types of Therapy Poetry Therapy http://www.youtube.com/watch?v=XBpSP8SuYjM&feature=related

  26. Prevalence • Very Hard to Determine • TBI occurs at a very high rate in children and youths  • Males more prone to TBI than females • "Silent Epidemic" • Moving from a low-incidence disability to a high-incidence disability

  27. Prevention • In the car... • Wear your seatbelt • Head rest in proper position • Children under the age of 13 should ride in the back seat. • Activities • Wear a helmet • Sports • Wear protective gear • Keep firearms and bullets stored in a locked cabinet or safe when not in use. http://www.health.state.ny.us/prevention/injury_prevention/traumatic_brain_injury.htm

  28. The Case of Anne Forrest 39-year-old Anne Forrest was an economist from Texas living in Washington, D.C. when she was rear-ended in a car accident on Saturday... What are some insights about living with TBI? What is typical and unique about her case compared with what has been presented?

  29. The Case of Natasha Richardson

  30. Case Study Actress Natasha Richardson died in 2009 following a seemingly minor skiing accident on the beginners' slope. She refused immediate medical attention, saying that she was fine. She later died from this accident. Here is an explanation of what happened. Could this death have been prevented? http://www.youtube.com/watch?v=szLRviF8kNk&feature=related

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