Secondary Brain Injury

Post-Concussion Syndrome (PCS) is considered a neurological disorder, which produce long-term concussive effects. PCS is a form of traumatic brain injury (TBI) and can be the result of one or multiple concussions (McKee et al. 2009). A concussion is characterized as a mild TBI (mTBI) (Stern et al. 2013). The term “mild” refers to the severity of the original physical trauma, and does not indicate the severity of symptoms following the injury. The American Academy of Neurology (1997) defines concussion as any alteration of mental status due to a biomechanical force affecting the brain with or without loss of consciousness. If concussive symptoms persist longer than 3 months, a patient is diagnosed with PCS (Gavett et al. 2011a;

Perhaps one of the least understood injuries is a Mild Traumatic Brain Injury (TBI), otherwise known as a concussion. Over 1,000,000 concussions occur the United States every year (Majerske et al., 2008), and can be caused by any blow to the head. It is likely that many concussions do not go diagnosed. 300,000 of these concussion have been contributed to sports related injury (Majerske et al., 2008), making the study of sports related concussions in athletes the most important and easiest subjects to study.

First you would assess the patient’s level of consciousness and orientation (LOC).LOC determines the patients level of consciousness by assessing the patients alertness by asking the patient simple questions i.e : what’s is your name and birth date? Do you know where you are? Do you know why you are here? Do you know what year it is? By asking those questions a nurse can determine a patient’s responsiveness, remote memory, speech pattern and mental status. If the patient is alert, the nurse may check the patient’s cranial nerves. If the patient successfully completes the cranial nerve exam, there is a high chance that the patient didn’t sustain any brain/nerve damage

The diagnosis and management of concussion is challenging due to often times the physical and cognitive examinations being normal and additional tests are also commonly normal. Assessing cognitive function by asking questions of orientation have inadequate sensitivity to detect mild TBI after head injury.

Finally, the remaining weaknesses of the GCS scale relate to the assessment of comatose patients. The GCS becomes unreliable in ongoing care for monitoring coma and recovery through vegetative or minimally conscious states, before returning to consciousness (Laureys, 2005).

It is also unclear if it is the brain injury itself that causes the result and if it is the same for healthy people.

Traumatic brain injuries (TBIs) in the military are a tangible threat to the men and women of the United States military. Operations in Iraq and Afghanistan have created a spotlight on this injury, as the “signature injury”. Specific criteria makeup the definition of a TBI, which is certain symptoms and severity levels of those symptoms. Due to the capacity of this injury, the Department of Defense (DoD) and Congress have created mandates, along with treatment methods, and the ability to achieve an end goal of aiding an individual’s complete recovery.

The Glasgow coma scale is the scoring system that monitors and assesses the level of consciousness of a patient that has had a traumatic injury e.g. brain injury, car accident or sports injury (Braine & cook, 2016). The Glasgow coma scale is a score between 3-15 with 3 being the worst and 15 being the best. This scale is composed of 3 sections which are the best eye response this assessment is important to assess the arousal of the patient which reflexes the integrity of reticular activating system of the brain which assesses by 1. No eye opening 2. Opens to pain 3. Opens to voice 4. Opens spontaneously, the best verbal response this assessment reflects the integrity of higher cognitive and interpretive centres of the brain. The verbal response depends on the language centre in the temporal lobe and in the frontal lobe which assess 1. No verbal response 2. Incomprehensive sounds 3. Inappropriate words 4. Confused 5. Orientated and best motor response this assessment check the function ability of the cerebral cortex, the patient has to understand the commands and perform the movement accordingly, they assess the upper extremities by simple orders because they are more reliable than the lower extremities this is assessed by 1. No motor response 2. Extension to pain 3. Flexion to pain 4. Withdrawals from pain 5. Localising pain 6. Obeys commands, these are the three sections that nurses needs to access (Elliot, Aitken & Chaboyer,

Knowing the symptoms of a brain injury is important but, getting treated is even more

Head (Brain) injury is known as a major public health problem that is a frequent cause of death and disability in young people, Among the many challenges that survivors of traumatic brain injury must face, behavior problems rank among the most difficult. Traumatic brain injury, or TBI, is a type of brain injury that occurs when trauma causes damage to the brain. It can cause when a person 's head suddenly or violently hits an object, or an object hits the person, and damages the brain tissue. A person with a TBI may remain conscious or he/she might be unconscious for a few minutes. Some symptoms of TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and trouble with memory, concentration, attention, or thinking. These symptoms might be experienced by any person with mild, moderate to severe TBI (Real Warriors).

Medical and technological advances have led to greater survival rates in individuals suffering from various illness and injury throughout history. This includes individuals who suffer traumatic and nontraumatic brain injuries. Approximately 1.5 million people in the United States sustain a brain injury each year with the survival rate of over 90 percent making brain injury the leading cause for disability in the United States. (Mysiw, Bogner, Corrigan, Fugate, Clinchot, & Kadyan 2006). Cognitive, physical, sensory and behavioral changes are widely noted in individuals in the months and years following a brain injury. However, the psychosocial, psychological and emotional effects of these injuries are less discussed and therefore these aspects can be overlooked when anticipating a course of treatment. Individuals who sustain acquired brain injuries experience significant, lasting impairment in the psychosocial, psychological and emotional aspects of their lives and better understanding of these issues can lead to better treatment and coping skills for these individuals.

A traumatic brain injury (“TBI”) occurs when the brain is somehow injured, rattled, or wounded from an external source of force. The means of acquisition and the severity of TBIs are unique to each patient; therefore, symptoms and rehabilitation can vary greatly depending on the patient’s condition following the incident and how they sustained the injury. The severity of a TBI is generally classified into one of three categories: mild, moderate, or severe, and this type of diagnostic criteria influences how a patient with TBI is treated by medical staff and rehabilitation specialists. TBIs can affect a specific part of the brain that was directly impacted, leaving the patients with only one or a few areas of impairment, or the damage can

Dementia produces physical changes in the brain and some areas shrink and other widen. Dementia is a term used to describe symptoms of mental or communication impairment found in a variety of brain conditions including Alzheimer’s disease (AD). In approximately 20% of the cases dementia can be reversed with the other 80% being irreversible. Dementia is generally marked by memory loss, forgetting appointments, forgetting the day of the week, which are all signs of cognitive impairment. Irritability and language difficulties are manifested in people with dementia. (Alzheimer’s Association, n.d.).

Traumatic brain injury (TBI) is a type of injury that is a critical public health and socio-economic problem. TBI is a leading cause of death and disability in both children and adults [5]. The Centers for Disease Control and

Brain foundation 2011, A-Z of disorders, Stroke, Brain Foundation, Sydney, viewed 30 June 2011, .