Traumatic Brain Injury
Definition
Traumatic brain injury (TBI) is a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.
The definition of TBI has not been consistent and tends to vary according to specialties and circumstances. Often, the term brain injury is used synonymously with head injury, which may not be associated with neurologic deficits. The definition also has been problematic with variations in inclusion criteria.
Glasgow Coma Scale
The Glasgow Coma Scale (GCS) defines the severity of a TBI within 48 hours of injury. * Spontaneous = 4 * To speech = 3 * To painful stimulation = 2 * No response = 1
Motor response * Follows commands = 6 * Makes localizing movements to pain = 5 * Makes withdrawal movements to pain = 4 * Flexor (decorticate) posturing to pain = 3 * Extensor (decerebrate) posturing to pain = 2 * No response = 1
Verbal response * Oriented to person, place, and date = 5 * Converses but is disoriented = 4 * Says inappropriate words = 3 * Says incomprehensible sounds = 2 * No response = 1
The severity of TBI according to the GCS score (within 48 h) is as follows: * Severe TBI = 3-8 * Moderate TBI = 9-12 * Mild TBI = 13-15
Ranchos Los Amigos Scale of Cognitive Functioning
The severity of deficit in cognitive functioning can be defined by the Ranchos Los Amigos Scale. * level I = No response * level II = Generalized response * level III = Localized response * level IV = Confused-agitated * level V = Confused-inappropriate * level VI = Confused-appropriate * level VII = Automatic-appropriate * level VIII = Purposeful-appropriate
TBI defined by the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine
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Traumatic brain injury (TBI) is a nondegenerative, noncongenital insult to the brain from an external mechanical force, possibly leading to permanent or temporary impairment of cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness.
The definition of TBI has not been consistent and tends to vary according to specialties and circumstances. Often, the term brain injury is used synonymously with head injury, which may not be associated with neurologic deficits. The definition also has been problematic with variations in inclusion criteria.
Glasgow Coma Scale
The Glasgow Coma Scale (GCS) defines the severity of a TBI within 48 hours of injury. * Spontaneous = 4 * To speech = 3 * To painful stimulation = 2 * No response = 1
Motor response * Follows commands = 6 * Makes localizing movements to pain = 5 * Makes withdrawal movements to pain = 4 * Flexor (decorticate) posturing to pain = 3 * Extensor (decerebrate) posturing to pain = 2 * No response = 1
Verbal response * Oriented to person, place, and date = 5 * Converses but is disoriented = 4 * Says inappropriate words = 3 * Says incomprehensible sounds = 2 * No response = 1
The severity of TBI according to the GCS score (within 48 h) is as follows: * Severe TBI = 3-8 * Moderate TBI = 9-12 * Mild TBI = 13-15
Ranchos Los Amigos Scale of Cognitive Functioning
The severity of deficit in cognitive functioning can be defined by the Ranchos Los Amigos Scale. * level I = No response * level II = Generalized response * level III = Localized response * level IV = Confused-agitated * level V = Confused-inappropriate * level VI = Confused-appropriate * level VII = Automatic-appropriate * level VIII = Purposeful-appropriate
TBI defined by the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine
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