Term
| Organic Impairments Diagnoses |
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Definition
| Tumors, CVA, Trauma, Diffuse damage |
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Term
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Definition
| Embolic stroke due to a Thrombosis: narrowed blood vessels blocked due to clot or clot in heart breaks off and clots brain artery |
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Term
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Definition
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Term
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Definition
| bleeding in the brain, aneurysm, AVM |
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Term
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Definition
| Stroke, Non-traumatic brain injury, Traumatic brain injury |
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Term
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Definition
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Term
| Non-traumatic brain injury |
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Definition
| Tumors, encephalopathy, anoxia |
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Term
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Definition
| mild, moderate, severe depending on loss of consciousness, diffuse axonal damage |
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Term
| Closed head injury: Primary injury |
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Definition
| Focal contusions: portions of prefrontal lobes, anterior or posterior temporal lobes pushed into boney protuberance of skull. Damage to the frontal lobes is the most common site of brain damage in closed head injury |
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Term
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Definition
| Duration of loss of consciousness, initial score on glascow coma scale, length of post-traumatic amnesia, rancho scale. |
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Term
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Definition
| You cannot have a brain injury if you do not hit your head, you do not have a brain injury if your MRI is negative, Hollywood coma, if you have an average IQ on a test then you do not have brain damage. |
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Term
| Cognitive/behavioral symptoms of brain damage |
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Definition
| Weakness/paralysis on one side, aphasia, circumlocution, word finding, word substitution, dysphagia, visual field cut or perceptual difficulties, attention, concentration, distracted, reading and math |
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Term
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Definition
| immediate, recent, short term, long term, delayed, new learning |
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Term
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Definition
| Retrograde, anterograde. Located in the temporal lobe/hippocampus |
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Term
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Definition
| In the past. Can not remember anything before the accident |
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Term
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Definition
| New/After. Can not remember anything immediately after the crash. |
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Term
| Symptoms of executive dysfunction |
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Definition
| Perseveration, concrete/not abstract reasoning, problem solving/judgment, impulse control, differentiate critical/noncritical, AWARENESS (frontal lobes as brakes, prevents anosognosia |
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Term
| Emotional reactions Right CVA |
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Definition
| Impulsive, lack interpersonal sensitivity, don't use feedback, difficult to work with |
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Term
| Emotional reactions Left CVA |
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Definition
| May have initial catastrophic reaction, severe depression as become aware of deficits. |
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Term
| Frontal lobe injury: EMployment barriers |
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Definition
| impaired organization and planning, decreased understanding of consequences of behavior, poor awareness, impulsive, "lose tact", disinhibited, limited acceptance of feedback. |
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Term
| Barriers to re-integration post TBI |
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Definition
| Behavior problems are present in 50% of persons who have had a brain injury. |
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Term
| challenges: barriers to reintegration |
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Definition
| Lack of insight, fatigue, slowed processing, impaired judgment, impulsivity, difficulty with memory and organization, behavior difficulties |
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Term
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Definition
| unable to see there is a problem and resisits help |
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Term
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Definition
| unable to plan, cannot count on being able to participate |
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Term
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Definition
| pulls for other to complete the task due to need for support, cues |
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Term
| Impaired judgment, impulsivity |
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Definition
| ready, aim, fire! Poor planning and decisions |
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Term
| Difficulty with memory and organization |
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Definition
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Term
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Definition
| Anger control problems, anxiety, depression |
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Term
| Characterological changes following brain injury |
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Definition
1) Reduced empathy, increase self centeredness
2) Reduced control, self-monitoring
3) Decreased planning, initiative
4) Emotional: apathy, silly, irritable, hypo or hypersexuality
5) Inability to profit from experience |
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Term
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Definition
| decisions that caregiver must take responsibility because the survivor cannot |
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Term
| Vocational issues are key |
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Definition
| 63% of traumatic brain injuries occur in teens/adults in the working population, ages 15-64. |
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Term
| Neuropsychological testing |
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Definition
Study of brain/behavior relationships.
Areas assessed:
attention/concentration, memory, problem solving, abstract reasoning, visuospatial, adjustment, executive functions, personality, motivation |
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Term
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Definition
50th percentile average
68% are within one SD of the mean
95% are within 2 SD of the mean |
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Term
| Areas of function affected post TBI |
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Definition
| Cognitive, medical (seizures, sleep apnea), sensory/perceptual, mobility, functional skills, social-emotional, vocational |
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Term
| Neuropsychological Evaluations |
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Definition
Study of brain-behavior relationships, existence and severity of deficits, differential diagnosis, recovery potential, treatment interventions, identifies functional deficits even in cases where MRI may not be sensitive enough to identify damage
(MildTBI: 85-90% normal MRI) |
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Term
| Components of a Neuropsychological evaluation |
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Definition
| Specific referral questions, record review, clinical interview: consistencies, motivation, standardized testing: compairisons based on age, sex, educational level, recommendations |
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Term
| Neuropsychological Impairment scale |
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Definition
Allows for comparison of self report vs. family report (magnify, minimize)
Allows for comparison of self report vs. test performance.
Assesses attention, concentration, memory, defensiveness, consistency, academic skills, frustration tolerance. |
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Term
| Neurophsycological testing Importance of Norms |
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Definition
| Importance of norms, stardized, intra and inter scatter (consistency), sample functions under various circumstances, "hold" tests to estimate pre-morbid functioning, timed vs. untimed, assessment of effort: behaviorally and tested. |
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Term
| Rey-Osterrieth Complex Figure Test (ROCF) |
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Definition
| A neuropsychological assessment in which examinees are asked to reproduce a complicated line drawing......permits the evaluation of different functions, such as visiospatial abilities, memory, attention, planning, and working memory (executive functions). |
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Term
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Definition
Ability to think flexibly, shift "set", problem solving, reasoning, jugdement.
IE: Category test (Halstead), Wisconsin Card sort test, comprehension, vocabulary. |
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Term
| Neuropsychological evaluation addresses: |
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Definition
| Best circumstances of learning, ability to perform consistently, social collaboration skills, environmental modifications, fatigue factors, self monitoring abilities, consistency of effort, magnification of symptoms, personality and adjustment. |
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Term
| Test to measure vailidity: |
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Definition
TOMM: test of memory malingering. A 50 item visual recognition test.
"while sensitive to malingering, the TOMM is insensitive to a wide range of neurological impairments, making it ideal for detecting exaggerated or deliberately faked memory impairment." |
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Term
| Organic factors of behavior/emotions |
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Definition
| Frontal lobe dyscontrol issues, including irritability, impulsiveness, anger control |
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Term
| Reactive components of behavior/emotions |
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Definition
| Depression, anxiety, social withdrawal. |
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Term
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Definition
| unable to develop alternatives |
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Term
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Definition
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Term
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Definition
| emotionally stuck, precludes acceptance and revised identity. |
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Term
| Depression as an emotional influence on cognition |
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Definition
| Slowed motor responses, decreased initiative/effort, decreased initial learning |
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Term
| Anxiety as an emotional influence on cognition |
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Definition
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Term
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Definition
| Reactive depression; suicide risk, anxiety further complicating recovery, aggressive/acting out potential, ego-centrism, overall psychological distress, medication management suggestions. |
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Term
| Neuropsycholoigcal evaluation-recommendations |
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Definition
| Functional, specific cognitive strategies, judgment and safety, coping and mood, activity pattern, therapy referrals, psychiatry/medication management. |
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Term
| More neuropsych recommendations |
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Definition
1)Cognitive enhancing medication
2) Job coaching to support organization, communication, responses in work environment. Evaluate work setting and process.
3) Ongoing psychotherapy related to anger, emotionality. |
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Term
| True/False: An acceleration/deceleration can lead to brain injury |
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Definition
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Term
| Mild Traumatic Brain Injury Diagnosis |
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Definition
| Brief loss of consciousness (0-30 min.), "dazed and confused", "in a fog", memory loss of events prior or after; post traumatic amnesia (<24 hours), focal neurological deficit, can be temporary, glascow coma scale 13-15, hospitalized less than 48 hours or not at all, commonly a blow to the head; often a sudden violent motion of the head (whiplash) |
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Term
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Definition
| A mild TBI, most have no loss of consciousness, adolesents are at an increased risk and take longer to recover, females may be more susceptible, there can be a delay in symptom onset. Early identification is critical to prevent further injury. |
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Term
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Definition
| THere are physical, metabolic, and chemical changes to the brain with this. |
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Term
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Definition
| Dizziness, headaches, memory loss, difficulty concentrating, etc. THese are increased with repeat concussions. |
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Term
| Immediate Concussion Symptoms |
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Definition
Headache, nausea, dizziness, vomiting, confusion, slurred speech, disorientation, fatigue, tinnitus, emotionality, memory deficit, delayed motor/verbal responses.
(after 36 hours 75% had problems with memory and thinking) |
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Term
| Areas of function affected post concussion |
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Definition
| COgnitive, medical (seizures, sleep apnea), sensory/perceptual, mobility, functional skills, social-emotional, vocational |
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Term
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Definition
| Decreased learning, slowed info processing, memory problems, decreased attention/comcentration, poor planning, decreased judgement, physical/mental fatigue, motion sickness/dizziness, sensitive to light, noise, crowds, busy environment, decreased initiation, changes in vision, taste, smell, sleep problems, word finding problems, motion sickness, inflexibility, increased fears/anxiety, depression, alcohol intolerance, mood swings, irritability, decreased emotional control (laugh/cry). |
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Term
| Diffusion Tensor Imaging (DTI) |
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Definition
Advanced MRI diagnostic method. Measure water diffusion in multiple directions.
-diffusion is high in intact axons
-diffusion is reduced after axonal injury
-it is not definitive, just the best we have at the moment. |
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Term
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Definition
| Commonly suggest temporal lobe damage, frontal lobe damage, hemispheric disconnection, arousal system damage |
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Term
| Value of neuropsychological evals |
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Definition
| Identifies functional deficits, addresses a wide range of skills, results establish a baseline for recovery and rehabilitation. |
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Term
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Definition
"promising indicator of which patients with concussions are likely to experince chronic deficits." Secreted by dying brain cells.
Elevated STNF protien associated with no improvement in processing speed testing 3 months after concussion. May be an important guide to treatment. |
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Term
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Definition
| Continued experience of varied symptoms. Decreased processing speeds. Short term memory problems. Irritability/depression. Fatigue/sleep disorder. Concentration problems. |
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Term
| Persistent post concussion symptoms |
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Definition
| dizziness is present in 25-30% of these patients. Vision problems present in 19%. Headache, memory, sleep problems common. Anxiety 45%; avoidance and safety-seeking. |
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Term
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Definition
| Not sure what you are doing is ok |
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Term
| Psychological consequences |
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Definition
| Perplexity, irritability, fatigue, depression, anxiety, OCD, social withdrawal. |
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Term
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Definition
| Unable to do more than one thing at a time |
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Term
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Definition
| Automatic is no longer automatic |
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Term
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Definition
| Condition in which the brain sweels rapidly and catastrophically after a person suffers a second concussion before recovering from the earlier one. The second concussion could occur minutes, days, weeks after the initial. Is often fatal or severe consequences. |
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Term
| Chronic Traumatic Encephalopathy |
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Definition
| Progressive degenerative disease found in individuals with multiple concussions. Mimics alzheimers. Neurological changes and build up of abnormal protein in brain. Any athlete who suffers more than one concussion can be at risk. |
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Term
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Definition
| Some researchers have suggested that PTSD may account for the long term effects of post concussion syndrome. Parallel list of symptoms. |
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Term
| Common symptoms in PTSD and MTBI |
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Definition
| Cognitive changes. confusion. Anxiety, possibly OCD and agoraphobia. Depression. Loss of sense of self, withdrawal. Anger control difficulties. Sleep difficulties. Inflexibility. Decreased emotional control. |
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Term
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Definition
| Dixziness, vertigo, blurred vision, disruption in saccades, headache, nausea, tinnitus (8th nerve) |
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Term
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Definition
Intervene immediately with education.
Rest is needed for recovery: cognitive, physical, no tech use!
Expert assessment: neuropsychological eval critical.
Therapy evals to address vestibular issues, functional changes, cognitive impairments.
Medical management (pain, psychiatry)
Vocational rehab.
Help client increase awareness, develop strategies in real life settings.
Improve physical and cognitive endurances.
Use stress management and pacing.
Recommend a gradual return to function.
Address "shaken sense of self".
Involve/educate the family. |
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Term
| Mood stabilizers for MTBI |
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Definition
| Depakote, tegretol. Frustration tolerance, irritability, disinhibition. |
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Term
| Cognitive enhancing for MTBI |
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Definition
| Arousal, memory, decrease neurogenic fatigue |
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Term
| Atypical anti-psychotics for MTBI |
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Definition
| thought organization, thought flexibility. |
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