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Pharmacy & Acute Care University
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Neurology 111

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  1. Hemorrhagic Stroke
    9 Topics
    |
    2 Quizzes
  2. Status Epilepticus
    10 Topics
    |
    2 Quizzes
  3. Myasthenia Gravis Exacerbation
    9 Topics
    |
    2 Quizzes
  4. Parkinson's Disease
    11 Topics
    |
    2 Quizzes
  5. Traumatic brain injury
    9 Topics
    |
    2 Quizzes
  6. Epilepsy
    9 Topics
    |
    2 Quizzes

Participants 396

  • Allison Clemens
  • April
  • ababaabhay
  • achoi2392
  • adhoward1
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Neurology 111 Traumatic brain injury Clinical Presentation
Lesson 5, Topic 5
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Clinical Presentation

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The signs and symptoms of traumatic brain injury (TBI) can vary substantially depending on multiple factors:

Injury Characteristics

  • Mechanism of injury: blunt force, penetrating, blast injury, etc.
  • Location of damage: cortical, subcortical, brainstem
  • Extent of damage: focal vs diffuse axonal injury
  • Severity: mild, moderate, severe per Glasgow Coma Scale

Timing

  • Initial presentation after the event
  • Early complications in hours to days
  • Later sequelae over months to years

Common Acute Symptoms

Symptoms frequently reported after a TBI event include:

  • Headache
  • Nausea/vomiting
  • Dizziness, vertigo
  • Confusion, memory problems, cognitive difficulties
  • Altered mental status: from mild confusion to coma

Focal Neurological Deficits

Some patients experience focal neurological symptoms correlating with areas of brain injury such as:

  • Weakness (hemiparesis)
  • Language deficits (aphasia)
  • Visual changes
  • Cranial nerve palsies

Severe Presentations

In severe cases with extensive damage or elevated intracranial pressure, additional findings may include:

  • Seizures
  • Abnormal posturing (decorticate/decerebrate)
  • Coma
  • Signs of herniation:
    • Pupillary asymmetry
    • Bradycardia
    • Hypertension
    • Irregular respirations

Complications of TBI

Both acute and delayed complications may arise after TBI related to the initial traumatic event as well as secondary injury cascades.

Acute Complications

In the initial period after TBI, possible complications include:

  • Hemorrhage (subdural, epidural, intraparenchymal)
  • Cerebral edema
  • Hydrocephalus
  • Infection (meningitis)

Delayed Complications

Later complications of TBI that may develop over months to years:

  • Diffuse axonal injury
  • Cerebrovascular injury
  • Post-traumatic epilepsy
  • Hormone deficiencies
  • Cognitive impairment (memory, attention, executive function)
  • Neuropsychiatric sequelae: depression, anxiety, aggression

Risk Factors for Complications and Poor Outcomes

  • Age
  • Medical comorbidities
  • Injury severity
  • Genetic factors
  • Pre-existing neuropsychiatric disorders

The presentation of TBI involves a spectrum ranging from mild concussion to severe injury with high risk of mortality and long-term disability. Careful evaluation of each patient’s specific constellation of symptoms, clinical course, and risk factor profile is needed to optimize outcomes.