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Lec 16 vascularization - lecture

Lec 16 vascularization - lecture - OT441:Foundationsof...

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OT 441: Foundations of  OT 441: Foundations of  Occupation - Neuroscience Occupation - Neuroscience Vascularization, TBI, & Stroke
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Outline Outline 1. Traumatic Brain Injuries 1. Vascularization 1. Cerebral Vascular Accident (CVA)
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Traumatic Brain Injury Traumatic Brain Injury An insult to the brain caused by  external physical force Not of degenerative or congenital  nature May produce a diminished or  altered state of consciousness May result in an impairment in  cognitive abilities or physical  functioning Can interfere with occupational  engagement
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Traumatic Brain Injury Traumatic Brain Injury Prognosis dependent on many factors Age Length of time in coma  Length of time of post-traumatic amnesia Size of brain injury Location of brain injury Cause of injury (ie: fall vs. gun)
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Epidemiology Epidemiology Males 14 – 24 at highest risk Followed by infants and the elderly ~1.4 million TBI per year in the US ~200,000 Americans die each year from their  injuries. ~500,000 are hospitalized Of the survivors: ~10% have mild-moderate problems that threaten  their ability to live indpendently ~200,000 have serious problems that may require  institutionalization or another form of close  supervision MVA leading cause (50%), falls, gun shot wounds For infants and those over the age of 75, leading  cause is falls. ~20% are due to violence ~HALF of TBIs involve alcohol Increased concern as war-related TBIs increase Outcomes dependent on cause
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Closed vs. Open  Closed vs. Open  TBI TBI Closed head injury Skull is intact; no  penetration of the skull Open head injury Penetration of the skull  with direct injury to the  brain
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Classify TBI: Focal Injury Classify TBI: Focal Injury Most common type of TBI Damage is confined to a specific area Direct impact of short duration, typically  related to acceleration/deceleration  forces  Coup-contra-coup: brain is hurled against  the skull; then it ricochets in the opposite  direction Frontal & temporal lobes are most often  damaged Force may fracture skull Causes contusions (bruises) and  hematomas (collections of blood –  usually clotted)
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Focal Injury Focal Injury
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Classify TBI: Diffuse Injury Classify TBI: Diffuse Injury Damage is diffuse and impacts  several areas of the brain Can occur from hypoxia, damage to  blood vessels, rotational forces Secondary damage: increased  intracranial pressure, swelling,  hemorrhage, oxygen deprivation
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Classify TBI: Diffuse Injury Classify TBI: Diffuse Injury Diffuse axonal injury: Shearing forces in the brain cause  tearing of axons or stretch to axon 
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