Physical Therapy

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Neuromuscular & Nervous Systems

Evaluation, Diagnosis, Prognosis

Amnesia

During your assessment of a patient with traumatic brain injury, which of the following signs or symptoms is most likely to be seen?

Assessment

Basilar Skull Fracture

What kind of fracture is it most important to assess for after a traumatic brain injury?

Change in LOC

Considerations

Diplopia

Halo or Ring Sign

During your assessment of a patient with traumatic brain injury, which of the following signs, symptoms, or diseases is most likely to be seen?

Increased Intracranial Pressure

Intracranial Bleeding

It is most important to consider which of the following scenarios during a traumatic brain injury assessment?

Location of Injury

Personality Changes

Posturing

Traumatic Brain Injury Assessment

CSF rhinorrhea is most likely present in which of the following conditions?

Brain Contusion

Hematoma formation is most likely associated with which of the following conditions?

Closed Head Injury

A brain contusion is an example of what type of head injury?

Comminuted Fracture

Which of the following types of head injuries is most likely the result of multiple linear fractures with depression of the skull into the brain?

Concussion

Which of the following is most likely associated with a closed head injury?

Coup and Contrecoup

Which of the following conditions is a head injury that does not penetrate the skull?

Depressed Fracture

Which of the following types of head injuries is most likely characterized by a sunken section of skull into the brain?

Linear Fracture

Which of the following is the most common type of skull fracture?

Open Fracture

Which of the following types of head injuries is most likely characterized by exposed brain tissue from a laceration to the scalp?

Open Head Injury

A depressed fracture is an example of which type of head injury?

Types of Head Injuries

Atherosclerosis

Which of the following is the most likely cause of thrombotic stroke?

Atrial Fibrillation

Which of the following diseases or disorders is most likely a cause of embolic stroke?

Embolic

Which of the following is most likely one of the two main types of ischemic strokes?

Hemorrhagic

Which of the following strokes is most likely to be caused by severe acute hypertension?

Ischemic

Which of the following stroke types is caused by disruption of normal blood flow to the brain?

Reversible Ischemic Neurologic Deficit (RIND)

Which of the following is best characterized by ischemia lasting between 24 hours and 3 weeks?

Severe Hypertension

Which of the following diseases or disorders is the most likely cause of hemorrhagic stroke?

Thrombotic

Which of the following stroke types is most likely characterized by a slow onset and is treated with anticoagulation?

Transient Ischemic Attack (TIA)

Which of the following stroke types most likely can also be called  “silent stroke”?

Types

Types of Strokes

Warning Signs

Brainstem

A lesion to this area of the brain presents with symptoms ranging from death or coma to contralateral hemiparesis, dilated pupils, nystagmus, vertigo, dysarthria, dysmetria, dizziness, and ataxia.

Cerebellum

A lesion to this area of the brain presents with ataxia, coordination loss,  contralateral hemiparesis, contralateral hemisensory loss, vertigo, nystagmus, dysphonia, dysphagia, dysmetria, dysarthria, horner's syndrome, tinnitus, and deafness. <br>

Contusion/ Parenchymal Hemorrhage

This type of TBI is caused by shearing of the parenchymal vessels and may result in frontal and temporal lobe damage presenting with coma, dilated pupils, hemiplegia, and spasticity.

Diffuse Axonal Injury

This type of TBI results from a rotational deceleration, such as a car accident, that tears the long connecting nerve axons in the brain.

Epidural Hematoma

This TBI lesion is caused by a skull fracture and presents with a lens shape bleed on a CT scan. <br>

Frontal Lobe

A lesion to this area of the brain causes expressive aphasia, delayed initiation, contralateral hemiparesis and hemisensory loss, incontinence, and gait apraxia. <br>

Intraventricular Hematoma

This type of TBI is caused by shearing of the parenchymal vessels, resulting in damage to the lateral and third ventricle by way of blood pooling resulting in hydrocephalus.

Lesions of the Brain and Presentations

Main TBI Lesions

Occipital Lobe

A lesion to this area of the brain causes contralateral blindness, difficulty recognizing objects, difficulty recognizing faces, and impairment loss in the ability to write.

Parietal Lobe

A lesion to this area of the brain causes difficulty with recognizing sensory input (temperature, vibration, light touch) and difficulty judging distances.

Subarachnoid Hemorrhage

This type of TBI results from bleeding between the arachnoid and pia mater resulting in the sensation of “the worst headache of my life” and a STAR sign on the CT scan.

Subdural Hematoma

This TBI lesion occurs beneath the dura but outside the brain on the lateral cerebral hemispheres. The acute form is caused by trauma, but the chronic form can occur without trauma or with minimal trauma.

Temporal Lobe

A lesion to this area of the brain causes Wernicke's receptive aphasia, forgetfulness, memory loss, vision loss, and hearing loss.

Stroke & Traumatic Brain Injury

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