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Brain Injury, Traumatic

Corey J Costanzo, DO, MPH, MS Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Traumatic brain injury (TBI) is defined as an alteration in brain function caused by an external force.

  • System(s) affected: neurologic; psychiatric; cardiovascular; endocrine/metaboli...

DIAGNOSIS

HISTORY

  • Loss of consciousness (LOC), headache, vomiting, amnesia, confusion, dizziness, sensitivity to light

  • Epidural hemorrhage from blunt trauma: 30% with a “lucid interval” (initial LOC fol...

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 hospitalizati...

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
Tsang  KK, Whitfield  PC. Traumatic brain injury: review of current management strategies. Br J Oral Maxillofac Surg.  2012;50(4):298–308. [View Abstract on Ov...

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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