| TRAUMATIC BRAIN INJURY |
| ELVIN THE ELEPHANT WHO FORGETS by H. Snyder and S. Beebe |
| IDEA DEFINITION OF TRAUMATIC BRAIN INJURY: An acquired injury to the brain caused by an external physical force, resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance. Traumatic brain injury applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition; language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor abilities; psychosocial behavior; physical functions; information processing; and speech. Traumatic brain injury does not apply to brain injuries that are congenital or degenerative, or to brain injuries induced by birth trauma. |
| ACQUIRED BRAIN INJURY: refers to both traumatic brain injuries, such as open and closed head injuries, and nontraumatic brain injuries, such as strokes and other vascular accidents, infectious diseases (e.g., encephalitis, meningitis), anoxic injuries (e.g., hanging, near-drowning, choking, anesthetic accidents, severe blood loss), metabolic disorders (e.g., insulin shock, liver and kidney disease), and toxic products taken into the body through ingestion or inhalation. The term does not refer to injuries that are congenital or brain injuries induced by birth trauma. |
| DESCRIPTORS OF TBI SEVERITY: Minor No loss of consciousness, head injury not seen by a physician, a minor bump. Mild Mild or transient loss of consciousness, if any; child may be lethargic and not be able to recall the injury; child may vomit (if more than three times, doctor should be alerted). Moderate Loss of consciousness is typically less than 5 minutes; on recovery, the child may be able to move spontaneously and purposefully; open eyes in response to pain. Older children or youth may be combative, telling others to 'leave me alone.' Severe Loss of consciousness ranges from 5 to 30 minutes. Surgery may be needed if skull is fractured significantly; neurological consequences are common. Serious Loss of consciousness more than 30 minutes; neurological consequences are typical. |
| TBI words (Alphabet): cerebellum -- Injury to this part of the brain can result in the inability to coordinate fine movement, loss of the ability to walk, and the inability to reach out and grab things. cerebral cortex -- The layer of cells on the outer surface of the cerebral lobes. Damage to this area can impair the brain’s ability to process emotions and behavior. cerebrospinal fluid -- Fluid that surrounds the brain, protecting it from impact with the skull. closed head injury -- Brain injury resulting from falls, car accidents, etc. Damage is usually diffuse, but there is no penetration of the skull. computed tomography (CT) -- An x-ray imaging technique by which computers create cross- sectional images of specific body areas or organs concussion -- A jarring injury of the brain resulting in disturbance of cerebral function. contusion -- extensive damage to the brain resulting in intense stupor. This condition is often the result of brutal shaking, violent blows, or other serious impacts to the head, which bruise brain tissue. Contusions can occur when a depressed skull fracture puts pressure on the brain, causing the blood vessels in the brain to burst and the brain tissue to swell. Contusions can also occur when the brain moves rapidly within the skull (called contrecoup). This sometimes happens during a car accident or as a result of shaken baby syndrome. Some severe contusions may require surgical removal or repair. deceleration injury -- impact injury to a body within or upon a rapidly moving object caused by the forces exerted when the object is brought to a sudden halt. Deceleration injury can occur in high- speed vehicles when they stop or slow down abruptly or when the occupants of the vehicle are propelled from it while it is moving. epidural hematoma -- the collection of blood between the skull and the covering of the brain, which puts pressure on vital brain structures. frontal lobe -- Injury to this portion of the brain can cause changes in emotional control, initiation, motivation, and inhibition. An intolerance for frustration and easily provoked aggressive behavior are typical. Promiscuity and lethargy may also result. hydrocephalus -- Increased cerebrospinal fluid inside the skull, compressing brain tissue and causing brain damage or even death. limbic system -- Damage to this portion of the brain distorts emotions and physical desires, leads to difficulty with organization/perception of the environment, and problems with balance and movement. It can also cause decreased vital capacity in breathing important for speech. magnetic resonance imaging (MRI) -- A magnetic imaging technique by which computers create cross-sectional images of specific body areas or organs. occipital lobe -- Damage to this portion of the brain can impair vision. It can cause a degree of blindness, difficulty with locating objects in the environment, identifying colors, inability to recognize movement of objects, difficulties reading and writing, and can cause hallucinating. open head injury -- Brain injury resulting from such things as bullet wounds, or other external forces that open the head and penetrates the skull. Damage can be extensive and fatal, but it is usually focal. parietal lobe -- Injury to this part of the brain impairs the ability to identify objects by touch, increases clumsiness and neglect on the side of the body opposite to the injury. It also can cause an inability to draw and follow maps. secondary injuries -- Swelling and release of chemicals due to a TBI promote inflammation and cell injury or death. Intracranial pressure increases and may cause brain damage. If it is not treated, it may swell into the base of the skull and cause respiratory failure or death. skull -- The bony structure that encases the brain. skull fracture -- a break, crack, or split of the skull resulting from a violent blow or other serious impact to the head. subdural hematoma -- the collection of blood between the covering of the brain and the brain itself, resulting in pressure on vital brain structures. temporal lobe -- Injury to this portion of the brain can cause unprovoked and very abrupt aggression. Damage here also causes both long-term and short- term memory loss and difficulty in learning new things, affecting the ability to relearn appropriate behavior. Damage here can also cause persistent talking. |
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| RISK FACTORS FOR TRAUMATIC BRAIN INJURY: Being a boy Being younger than 5 years old Being between 15 and 24 years old Being older than 70 years old |
| Symptoms of TBI: Medical/Neurological Sensory deficits Decreased coordination Difficulty breathing Dizziness Headache Impaired balance Partial or full paralysis Poor eye-hand coordination Reduced strength Seizures Sleep disorders Loss of intellectual abilities Cognitive Decreased attention Decreased organization Decreased problem solving Decreased abstract reasoning Integration problems Memory deficits Perceptual deficits Poor concentration Poor judgment Rigidity of thought Slowed information processing Poor short and long term memory Word finding difficulty Behavioral/Emotional Aggressive behavior Denial Depression Reduced inhibitions Distractibility Feelings of worthlessness Flat affect Low frustration level Extreme guilt Helplessness Impulsivity Inappropriate emotions Irritability Social Skills Development Difficulty maintaining relationships Inability to restrict inappropriate behavior Inappropriate responses to environment Insensitivity to others Limited initiation of social interactions Social isolation |
| Possible causes of brain injuries: Falls, automobile wrecks, bullet wounds, violent shaking, blows to the head, assaults, being struck by or against something, ... Chemicals -- pesticides, herbicides, insecticides, solvents, carbon monoxide, lead, etc. Anoxia -- If blood flow to the brain is depleted of oxygen, irreversible brain damage can occur. Heart attacks, respiratory failure, falling blood pressure, low oxygen, lack of oxygen, etc. Tumors -- If one of these grows in, on, or over the brain, or on one of the cranial nerves, damage can occur. Direct damage occurs if the tumor invades brain space; or damaged due to pressure. Corrective measures (surgery) may also cause brain damage. Infections -- The brain and surrounding tissues are very susceptible to infections if the special blood-brain protective system is breached. Viruses and bacteria can cause serious and life-threatening diseases of the brain (encephalitis) or surrounding tissues (meningitis). Stroke -- If blood flow to the brain is blocked through a cerebral vascular accident (stroke), cell death in the area of deprived blood will result. If there is bleeding in or over the brain (hematoma or hemorrhage) because of a tear in an artery or vein, loss of blood flow can also result in brain damage. |
