Download Understanding Traumatic Brain Injury

Objectives
0 Participants will be able to identify 4 characteristics of
a healthy brain.
0 Participants will be able to state the functions of the
brain.
0 Participants will be able to identify 3 types of brain
injuries.
0 Participants will be able to identify 3 different
teaching strategies to implement in the classroom.
The Healthy Brain
0 The skull protects the brain.
0 The brain is made up of neurons.
0 The neurons form tracts that route through the brain.
0 The nerve tracts carry messages to the various parts
of the brain.
0 The messages that are carried are used to perform
various functions.
Functions of the Brain
0 The brain is divided into main functional sections
called lobes.
0 The lobes each have their own functions.
0 The lobes are as follows: Frontal, Temporal, Parietal,
Occipital, Cerebellum and Brain Stem.
The Brain
Types of Brain Injuries
0 Hematoma (subdural)
0 Anoxic
0 Hypoxic
0 Diffuse
Closed vs open head injury: Closed nothing is
penetrating,or fracturing the skull, open is something
went through the skull.
Hematoma
Definition of Subdural Hematoma
0 : Bleeding into the space between the dura (the brain
cover) and the brain itself. This space is called the
subdural space. If the hematoma puts increased
pressure on the brain, neurological abnormalities
including slurred speech, impaired gait, and dizziness
may result and progress to coma and even death.
Anoxic Brain Injury
0 Anoxic Brain Injury and Hypoxic Injury
0 A prolonged lack of oxygen (anoxic brain injury) and a
decreased flow of oxygen (hypoxic injury) can cause
moderate to severe brain injuries, depending on how
long a patient is without sufficient oxygen. Both
conditions can accompany a traumatic brain injury
and other illnesses
Hypoxic Brain Injury
0 Hypoxic brain injury is caused by a decrease in the
supply of oxygen going to the brain. It differs from
anoxic brain injury because anoxia means there is no
oxygen going to the brain. That does not mean that a
hypoxic brain injury is any less severe. Examples:
carbon monoxide poisoning, near drowning, choking,
and cardiac arrest.
Diffuse axonal brain injury
0 Diffuse axonal brain injury is caused by the movement
of the brain within the skull, there is tearing of the
brain tissue and the swelling that can occur. These
movements, which are normally a back and forth type
of movement, disrupt the nerve cells which allow the
neurons to send messages between them. Once those
cells are disrupted and the links between them
broken, the signally process can not occur and
functions like movement, speech, and even those that
support life can cease.
Understanding the Terminology
for Traumatic Brain Injury
0 Glasgow Coma Scale: (GCS) Measure of post injury
responding including eye,verbal, and motor response.
0 This is a clinical tool to measure the intensity of gross
neurological function.
0 Mild (13-15)
0 Moderate (9-12)
0 Severe (3-8)
Rancho Levels
0 Rancho Los Amigos Levels of Recovery from traumatic
brain injury.
0 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
Why is this info important
0 Understanding the terminology demystifies what is
being written in the reports.
0 Helps to understand what part of the brain is injured.
0 By knowing what kind of brain injury and the parts of
the brain involved, the teacher can develop
appropriate goals and strategies.
Injuries to the Brainstem
0 The brainstem regulates major life-support functions.
(breathing, thinking, moving)
0 Injury to the brainstem produces slow thinking, easy
fatigue, sleep disturbances,impaired balance and
coordination, and or losses of sensation and
movement.
Injuries to Frontal Lobe
0 Frontal lobe injuries most often affect executive
functions like, impulse control, initiation
planning,organization, mental flexibility, and
monitoring for errors. Injury in this area also produce
susceptibility to mental overload.
Parietal Lobe Injuries
0 Injuries in this area, produce perceptual impairment,
language comprehension deficits, safety issues,
judgement disorder and difficulty making sense of self
and others. The lobe is situated towards the back of
the brain, and has three functions.
Three Jobs
0 First, processes input of sensations from the body to
the brain. ( difficulty recognizing changes in their
body state).
0 The parietal lobe contains the “locator” circuits of the
brain that tells where things are found and where they
are situated in respect to the body. (greater risk of
losing their way).
0 The third part and most important function is its high
level of processing all the brain’s input data.
Parietal lobe
0 The left parietal lobe generates understanding of
ideas expressed in words, including stories, articles
explanations, and requests.
0 The right parietal lobe gives the “big picture” both in
visual images and in forming ideas. Reading of
emotions, and nonverbal communications may be
diminished. This part of the brain takes over in
emergencies. Also is involved in the early stages of
learning any new skill. Depth perception, shapes and
contours are also part of this lobe.
Temporal Lobe Injuries
0 Injuries here can impair the ability to interpret
sounds. Sensitivity to noise.
0 Injury to the back of the temporal lobe can produce
aphasia, or loss of the ability to understand speech.
Injury to the right temporal hemisphere compromises
the person’s ability to perceive emotions.
0 Temporal lobe contains the circuitry of the system
that produces memory and emotional responses.
Occipital Lobe Injuries
0 The occipital lobes are a small region at the rear of the
brain where sensory input from the eyes is processed.
Occipital injury produces problems in recognizing and
identifying visual stimuli.
Cerebellum Injuries
0 Loss of ability to coordinate fine movements.
0 Loss of ability to walk.
0 Inability to reach out and grab objects.
0 Tremors.
0 Dizziness (Vertigo).
0 Slurred Speech (Scanning Speech).
0 Inability to make rapid movements.
Vision changes
0 Homonymous hemianopsia, also referred to as
homonymous hemianopia is the loss of half of the field of
view on the same side in both eyes. It occurs frequently in
traumatic brain injuries, because of the manner in which
the nasal nerve fibers from each eye cross as they pass to
the back of the brain. The visual images that we see to the
right side travel from both eyes to the left side of the brain,
while the visual images we see to the left side in both eyes
travel to the right side of the brain. Therefore, damage to
the right side of the posterior portion of the brain can
cause a loss of the left field of view in both eyes. Likewise,
damage to the left posterior brain can cause a loss of the
right field of vision.
Visual skills affected by
Traumatic Brain Injury include:
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Tracking:
the ability of the eye to move smoothly across a printed page or while following a
moving object.
Fixation:
quickly and accurately locating and inspecting a series of stationary objects, such
as words while reading.
Focus Change:
looking quickly from far to near and back without blur.
Depth perception:
judging relative distances of objects - how far or near they are.
Peripheral vision:
monitoring and interpreting what is happening in the surrounding field of vision
Binocularity:
using both eyes together as a team - smoothly, equally and accurately
Visual skills Affected
0 Maintaining attention:
0 keeping focused on a particular activity while interference, such as
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noise, is present.
Visualization:
accurately picturing images in the "mind's eye," eye retaining and
storing them for future recall.
Near vision acuity:
clearly, seeing, inspecting, identifying and understanding objects
viewed within arm's length.
Distance acuity:
clearly seeing, inspecting, identifying and understanding objects
viewed at a distance.
Vision perception:
understanding what is seen.
Resources
0 www.child-psych.org/2009/04/long-term-effects-of-
traumatic-brain.html
0 http://www.biausa.org/brain-injury-children.htm
0 www.bianys.org/learnet
0 http://www.projectlearnet.org/what_problems_are_s
een.html
0 http://cokidswithbraininjury.com/educators-andprofessionals/manual/