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Brain Injury, Traumatic

Caleb J. Mentzer, DO and James R. Yon, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Traumatic brain injury (TBI) is defined as an alteration in brain function or other evidence of brain pathology, caused by an external force.

  • System(s) affected: neurologic; psychiatr...

DIAGNOSIS

HISTORY

  • Loss of consciousness (LOC), headache, vomiting, amnesia

  • Epidural hemorrhage from blunt trauma: 30% with a “lucid interval” (initial LOC followed by recovery of consciousness and then ...

TREATMENT

GENERAL MEASURES

  • Acute management depends on injury severity. Most patients need no interventions.

  • Immediate goal: Determine who needs further therapy, imaging studies (CT), and hospitalizatio...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

  • Schedule regular follow-up within a week to determine return to activities.

  • Rehabilitation indicated following a significant acute injury. Set realistic goals.

  • For ...

REFERENCES

1
1 Rosenfeld JV, McFarlane AC, Bragge P, et al. Blast-related traumatic brain injury. Lancet Neurol.  2013;12(9):882–893. {L-End} {L-End} [View Abstract on OvidMedline]
2
2 McCrory P,...

CODES

ICD10

  • S06.9X0A Unsp intracranial injury w/o loss of consciousness, init

  • S06.5X0A Traum subdr hem w/o loss of consciousness, init

  • S06.6X0A Traum subrac hem w/o loss of consciousness, init

  • S06.0X0A Co...

CLINICAL PEARLS

  • TBI involves two distinct phases: the primary mechanical insult and secondary dysregulation of the cerebrovascular system with cerebral edema, ischemia, and cell-mediated death.

  • Indicat...

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