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Traumatic Injuries: Traumatic Brain Injury

Traumatic Injuries: Traumatic Brain Injury. KNR 279. TRAUMATIC BRAIN INJURY.

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Traumatic Injuries: Traumatic Brain Injury

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  1. Traumatic Injuries:Traumatic Brain Injury KNR 279

  2. TRAUMATIC BRAIN INJURY • Insult to brain, not of degenerative or congenital nature, but caused by an external force that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive or physical functioning • Open or closed injury • Mild (concussion) to severe (coma)

  3. INCIDENCES OF TBI • Over 2-5 million in US • 1 injury every 15 seconds • Many result in life long disability • 56,000 killed annually • Leading cause of death among Americans under 45 • Males 14-24 have highest rate

  4. CAUSES OF TBI • 50% Motor vehicle crashes • 21% Falls • 12% Violence • 10% Sports & recreation • 7% Other

  5. Symptoms: Frontal Lobe/Foreheadwww.braininjury.com • Paralysis • Problems sequencing for multi-step task • Persistence of a single thought • Inability to focus on task • Mood changes/emotional liability • Changes in personality • Difficulty with problem solving • Inability to express language

  6. Parietal Lobe/ Near back & top of head • Inability to attend to more than 1 object at a time • Inability to name an object • Inability to locate words for writing • Problems reading • Difficulty with drawing tasks • Difficulty to distinguish left from right • Difficulty with math • Difficulty with eye-hand coordination

  7. Occipital Lobes: Back of head • Defects in vision (visual field cuts) • Difficulty locating objects in the environment • Problems identifying colors • Difficulties with reading & writing • Visual illusions (inaccurately seeing objects)

  8. Temporal Lobes: Side of head above ears • Difficulty recognizing faces • Difficulty in understanding spoken words • Short term memory loss • Interference with long term memory • Inability to categorize objects • Right lobe can cause persistent talking • Increased aggressive behavior

  9. Brain stem: Deep within brain • Difficulty swallowing food & water • Problems with balance & movement • Dizziness & nausea • Sleeping difficulties • Decreased vital capacity in breathing needed for speech

  10. Cerebellum: Base of skull • Loss of ability to coordinate fine movements • Loss of ability to walk • Tremors • Slurred speech • Inability to make rapid movements

  11. EFFECTS OF TBI • Balance or equilibrium • Behavior / emotion • Cognitive • Physical • Seizures • Speech / language

  12. Glasgow Coma Scale

  13. Ranchos Los Amigos ScaleLevel of Cognitive Functioning / Recovery • I = No response, comatose • II = Generalized response, nonpurposeful, inconsistent • III = Localized response, inconsistent reaction to specific stimuli • IV = Confused, agitated, nonpurposeful behavior, inability to process information

  14. Ranchos Los Amigos ScaleLevel of Cognitive Functioning / Recovery • V = Confused, inappropriate, nonagitated behavior, alert, highly distractible, responds to simple commands • VI = Confused but appropriate behavior, goal-directed, uses external input for direction

  15. Ranchos Los Amigos ScaleLevel of Cognitive Functioning / Recovery • VII = Automatic, appropriate behavior, robot like compliance with routine, shallow recall, increased awareness of others • VIII = Purposeful, appropriate behavior, alert, oriented, independent functioning

  16. Recommended TR Interventions • I, II, III = Sensory stimulation, passive stretching, art, movement to music, cognitive retraining, reality orientation • IV, V, VI = Aquatic therapy, expressive arts, leisure education, horticulture, behavior management, stretching & flexibility exercises, table & board games • Carter, Van Andel, & Robb, 2003

  17. Recommended TR Interventions • VII, VIII = Computer games, Community integration, expressive arts, social skills training • Carter, Van Andel, & Robb, 2003

  18. Considerations/Accommodations • Decrease distractions in environment • Provide repetition & consistency • Demonstrate new tasks & provide examples • Help with planning • Behavior management • Guidance with appropriate behavior in social situations • May not remember that just asked question

  19. Considerations/Accommodations • Structure • Start with simple tasks & small steps • Give clear, concrete directions • Supervise, may not know own limitations

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