Moderate to Severe Traumatic Brain Injury

:-(( this is what I was diagnosed with and suffer.... I look great BUT invisible wounds that have changed me forever.. Yes I may still recover more since it's only been 21months (happened May 13, 2010) ~~BritaJan

(((I added below € beside what I'm still dealing with)))

Borrowed from awesome site
http://www.traumaticbraininjury.com


Brain injuries can range in scope from mild to severe.

Traumatic brain injuries (TBI) result in permanent neurobiological damage that can produce lifelong deficits to varying degrees.

Moderate to severe brain injuries typically refer to injuries that have the following characteristics:

€**Moderate brain injury is defined as a brain injury resulting in a loss of consciousness from 20 minutes to 6 hours and a Glasgow Coma Scale of 9 to 12. ( my ICU records state I had a 9)

**Severe brain injury is defined as a brain injury resulting in a loss of consciousness of greater than 6 hours and a Glasgow Coma Scale of 3 to 8


The impact of a moderate to severe brain injury depends on the following:

--Severity of initial injury
--Rate/completeness of physiological recovery
--Functions affected
--Meaning of dysfunction to the individual
--Resources available to aid recovery
--Areas of function not affected by TBI

The impact of a moderate to severe brain injury can include:

€-Cognitive deficits including difficulties with:
ۥAttention
ۥConcentration
ۥDistractibility
ۥMemory
ۥSpeed of Processing
ۥConfusion
ۥPerseveration
ۥImpulsiveness
ۥLanguage Processing
ۥ"Executive functions"


€-Speech and Language

€not understanding the spoken word (receptive aphasia)
€difficulty speaking and being understood (expressive aphasia)
•slurred speech
€speaking very fast or very slow. €problems reading
€problems writing


-Sensory

€difficulties with interpretation of touch, temperature, movement, limb position and fine discrimination


-Perceptual

€the integration or patterning of sensory impressions into psychologically meaningful data


-Vision

•partial or total loss of vision
•weakness of eye muscles and double vision (diplopia)
•blurred vision
•problems judging distance
•involuntary eye movements (nystagmus)
ۥintolerance of light (photophobia)


-Hearing

ۥdecrease or loss of hearing
€ringing in the ears (tinnitus)
•increased sensitivity to sounds


-Smell

€loss or diminished sense of smell (anosmia)


-Taste

€loss or diminished sense of taste


-Seizures

•the convulsions associated with epilepsy that can be several types and can involve disruption in consciousness, sensory perception, or motor movements


-Physical Changes

•Physical paralysis/spasticity
€Chronic pain
•Control of bowel and bladder
€Sleep disorders
€Loss of stamina
€Appetite changes
€Regulation of body temperature
€Menstrual difficulties


-Social-Emotional

€Dependent behaviors. €Emotional ability
€Lack of motivation
€Irritability
€Aggression
€Depression
€Disinhibition
€Denial/lack of awareness

(((( I believe I've gone thru depression, even suicidal for over first year, over that!!! Went thru grieving stages which included the depression , grieved the looses I've gone thru caused by my Tbi changed me, my life!! And forgave myself for accident, injures, losses.. In Nov 2011--- been in peace, hopeful kind happy laugh cheer love and love the new me... Moving forward stride by stride, do not look back and focus on what I was what I lost and also do not focus on the next stride (future))~~BritaJan

Mild Traumatic Brain Injury--- Moderate & Severe have these plus other

A traumatic brain injury (TBI) can be classified as mild if loss of consciousness and/or confusion and disorientation is shorter than 30 minutes. While MRI and CAT scans are often normal, the individual has cognitive problems such as headache, difficulty thinking, memory problems, attention deficits, mood swings and frustration. These injuries are commonly overlooked. Even though this type of TBI is called "mild", the effect on the family and the injured person can be devastating.

Other Names For Mild TBI

Concussion
Minor head trauma
Minor TBI
Minor brain injury
Minor head injury
Mild Traumatic Brain Injury is:

Most prevalent TBI
Often missed at time of initial injury
15% of people with mild TBI have symptoms that last one year or more.
Defined as the result of the forceful motion of the head or impact causing a brief change in mental status (confusion, disorientation or loss of memory) or loss of consciousness for less than 30 minutes.
Post injury symptoms are often referred to as post concussive syndrome.
Common Symptoms of Mild TBI

Fatigue
Headaches
Visual disturbances
Memory loss
Poor attention/concentration
Sleep disturbances
Dizziness/loss of balance
Irritability-emotional disturbances
Feelings of depression
Seizures
Other Symptoms Associated with Mild TBI

Nausea
Loss of smell
Sensitivity to light and sounds
Mood changes
Getting lost or confused
Slowness in thinking
These symptoms may not be present or noticed at the time of injury. They may be delayed days or weeks before they appear. The symptoms are often subtle and are often missed by the injured person, family and doctors.

The person looks normal and often moves normal in spite of not feeling or thinking normal. This makes the diagnosis easy to miss. Family and friends often notice changes in behavior before the injured person realizes there is a problem. Frustration at work or when performing household tasks may bring the person to seek medical care.

Glasgow Coma Scale

I've been told I had a 9, so sadly must likely effected for life not just years of a slow recovery



There are a few different systems that medical practioners use to diagnose the symptoms of Traumatic Brain Injury. This section discusses the Glasgow Coma Scale.

The Glasgow Coma Scale is based on a 15 point scale for estimating and categorizing the outcomes of brain injury on the basis of overall social capability or dependence on others.

The test measures the motor response, verbal response and eye opening response with these values:

I. Motor Response
6 - Obeys commands fully
5 - Localizes to noxious stimuli
4 - Withdraws from noxious stimuli
3 - Abnormal flexion, i.e. decorticate posturing
2 - Extensor response, i.e. decerebrate posturing
1 - No response

II. Verbal Response
5 - Alert and Oriented
4 - Confused, yet coherent, speech
3 - Inappropriate words and jumbled phrases consisting of words
2 - Incomprehensible sounds
1 - No sounds

III. Eye Opening
4 - Spontaneous eye opening
3 - Eyes open to speech
2 - Eyes open to pain
1 - No eye opening

The final score is determined by adding the values of I+II+III.

This number helps medical practioners categorize the four possible levels for survival, with a lower number indicating a more severe injury and a poorer prognosis:

Mild (13-15):

-loss of consciousness and/or confusion and disorientation is shorter than 30 minutes.
-The symptoms are often subtle and are often missed by the injured person, family and doctors.
-The person looks normal and often moves normal in spite of not feeling or thinking normal. This makes the diagnosis easy to miss.


Moderate Disability (9-12):

-Loss of consciousness greater than 30 minutes
-Physical or cognitive impairments which may or may resolve
-Benefit from Rehabilitation


Severe Disability (3-8):

-Coma: unconscious state. No meaningful response, no voluntary activities


Vegetative State (Less Than 3):

-Sleep wake cycles
-Aruosal, but no interaction with environment
-No localized response to pain

Persistent Vegetative State:

-Vegetative state lasting longer than one month


Brain Death:

-No brain function
-Specific criteria needed for making this diagnosis