Prevention factors (protective factors) To prevent commotio cerebrie/head trauma (TBI), care must be taken to reduce accidents and falls. See, among other things, the respective workplace regulations. Sports at risk: ice hockey, soccer, basketball, baseball Note: In the United States, juvenile football players are prohibited from playing headers. Helmet obligation when cycling and motorcycling note! … Traumatic Brain Injury: Prevention
The following symptoms and complaints may indicate a traumatic brain injury (TBI): Grade 1 Short-lasting loss of consciousness Subsequent drowsiness and deceleration Confusion (also instead of unconsciousness). Amnesia (memory lapse) Cephalgia (headache) Vertigo (dizziness) Seizure Visual disturbances such as diplopia (double vision, double images). Hearing loss (hypacusis) Nausea (nausea), vomiting Disturbances of heart rate, blood … Traumatic Brain Injury: Symptoms, Complaints, Signs
Pathogenesis (development of disease) Violence acting on the skull causes both primary and secondary damage. In grade 1 traumatic brain injury (TBI), there are usually no detectable changes in the brain. From grade 2, there is tissue injury, hemorrhage, and/or perifocal (“located around a focus of disease”) edema (“swelling” or “water retention”) formation, which causes … Traumatic Brain Injury: Causes
The following are the most important diseases or complications that may be contributed to by traumatic brain injury: Respiratory system (J00-J99) ARDS (adult respiratory distress syndrome) – acute respiratory failure (“shock lung“). Blood, hematopoietic organs – immune system (D50-D90). Blood coagulation disorders, unspecified Endocrine, nutritional, and metabolic disorders (E00-E90). Pituitary insufficiency – hypofunction of the … Traumatic Brain Injury: Complications
Traumatic brain injury (TBI) is classified as follows: Grade 1 – Commotio cerebri (concussion; S06.0); in this case, no permanent damage is present Grade 2 – Contusio cerebri (cerebral contusion; S06.3); there is open or closed damage to the brain Grade 3 – Compressio cerebri (cerebral contusion; S06.2); open or closed damage to the brain … Traumatic Brain Injury: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps. Assessment after traumatic brain injury (TBI) is performed using the Glasgow Coma Scale. According to this, TBI can be classified as follows: Craniocerebral Trauma (TBI) Glasgow Coma Scala Unconsciousness Mild TBI 13-15 points up to 15 minutes Moderately severe TBI 9-12 points up … Traumatic Brain Injury: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Fasting glucose (fasting blood sugar) Blood gas analysis (BGA) Thyroid parameters – TSH Liver parameters – alanine aminotransferase (ALT, GPT), aspartate aminotransferase (AST, GOT), glutamate dehydrogenase (GLDH) and gamma-glutamyl transferase (gamma-GT, GGT). Renal parameters – urea, creatinine, creatinine … Traumatic Brain Injury: Test and Diagnosis
Obligatory medical device diagnostics. Computed tomography of the skull (cranial CT, cranial CT, or cCT)-for evaluation of acute craniocerebral injury, in cases of high (intermediate) risk for intracranial injury (brain injury): GCS (Glasgow Coma Scale) < 13, (GCS: 13-15); children: < 14. Loss of consciousness > 5 min; (< 5 min). Amnesia (form of memory … Traumatic Brain Injury: Diagnostic Tests
1st order. Depending on the findings, surgical therapy may be required. This is especially true for space-occupying, intracranial (“localized within the skull“) injuries. For epidural hematoma (EDH), a surgical indication exists for: Focal neurologic deficits GCS* ≤ 8 Space-occupying EDH with the following radiological characteristics: Width of the EDH > 15 mm Volume of the … Traumatic Brain Injury: Surgical Therapy
General measures Immediately make an emergency call! (Call number 112) Ensure vital functions with the aim of normovolemia and normotension; if necessary, administration of a 0.9% NaCl infusion solution Stabilization of the cervical spine should be performed.If the patient has unstable circulatory conditions, it must be weighed whether the installation of a cervical support is … Traumatic Brain Injury: Therapy
The anamnesis (medical history) represents an important component in the diagnosis of traumatic brain injury. If the patient is unresponsive himself or herself, the discussion is with family members/contact persons. Family history Social anamnesis Current anamnesis/systemic anamnesis (somatic and psychological complaints). Can you describe the mechanism of the accident? For car accidents: describe (extraneous history: … Traumatic Brain Injury: Medical History
If there is no definite evidence of an accidental event, the following differential diagnoses may be considered for a person who is impaired in consciousness. Diseases that may cause impaired consciousness: Respiratory system (J00-J99) Coma hypercapnium – coma caused by a marked increase in the level of carbon dioxide in the blood. Endocrine, nutritional and … Traumatic Brain Injury: Or something else? Differential Diagnosis
