Traumatic Brain Injury (TBI)

Authors

Affiliations

Nate Yomogida, B.S., SPT

Doctor of Physical Therapy

B.S. in Kinesiology

Chloë Kerstein, B.S., SPT

Doctor of Physical Therapy

B.A. in Neuroscience

Resources

• Suzanne - Ch12 TBI^{martinNeurologicInterventionsPhysical2021a?}
• Ch19 TBI¹
• ch33 TBI²
• Sleep
  • Ch32 Pathophysiology of sleep-wake disturbances after TBI³
  • Ch108 Sleep Disorders after TBI³

Severity

There are 3 general categories to quantify the severity of a TBI:

1. Mild TBI
2. Moderate TBI
3. Severe TBI

These items an be subcategorized into complicated and uncomplicated⁴

Mild TBI (mTBI)

• mTBI is diagnosed in patients with a GCS score of 13–15⁵

Complicated mild TBI

• CT Scan: Abnormalities
  • Hematoma⁴
  • Subarachnoid or subdural bleed⁴
  • Midline shift⁴
  • Fractures⁴

Uncomplicated mild TBI

• Head CT Scan: Normal
• More likely to have a resolution of symptoms in less than 3 months

Moderate TBI

moderate TBI in those with a GCS score of 9–12⁵

Severe TBI

GCS score \(\leq 8\)⁵

Treatment

Buffalo Concussion Treadmill Test

• Helps to work know how to grade exercise to increase activity tolerance
• Work up to 80% of HR at sx onset

References

1.

Fulk GD, Chui KK, eds. O’Sullivan and Schmitz’s Physical Rehabilitation. 8th ed. F. A. Davis Company; 2024.

2.

Goodman C, Fuller K. Goodman and Fuller’s Pathology. 5th ed. Elsevier, Inc; 2020.

3.

Kryger MH, Roth T, Goldstein CA. Kryger’s Principles and Practice of Sleep Medicine - E-book. Elsevier Health Sciences; 2021. https://books.google.com/books?id=yDVVEAAAQBAJ

4.

Permenter CM, Fernández-de Thomas RJ, Sherman A l. Postconcussive Syndrome. In: StatPearls. StatPearls Publishing; 2024. Accessed March 3, 2024. http://www.ncbi.nlm.nih.gov/books/NBK534786/

5.

Sussman ES, Pendharkar AV, Ho AL, Ghajar J. Mild traumatic brain injury and concussion: Terminology and classification. Handbook of Clinical Neurology. 2018;158:21-24. doi:10.1016/B978-0-444-63954-7.00003-3