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rajeevkrishnadas

TBI

3 posts in this topic

PLEASE COMMENT ON ANSWERS... and Correct... THanKs

1. Mild depression can occur after head injury. TRUE (didnt understand why mild depression)

2. In cases of head injury the amnesia usually ends suddenly. FALSE ( usually occurs in stages; sudden recovery possibly suggests dissociative amnesia)

3. In cases of head injury the duration of post-traumatic amnesia (PTA) reflects the severity of brain damage. TRUE

4. In recovery after severe closed head injury, the best prognostic indicator is the duration of post-traumatic amnesia. TRUE (NOTP)

GCS of 13–15; LOC < 30 minutes; PTA of less than 1 hour - mild

GCS of 9–12; LOC 30mts – 24 hours, PTA - 1 hour to 24 hours - moderate

GCS of 8 or less, LOC > 24 hours; PTA > 1 day - severe TBI.

These values kind of vary between books....

5. In cases of head injury islets of preserved memory can occur within the amnesic gap. TRUE NOTP - Pg 445

6. In cases of head injury post-traumatic amnesia can occur without retrograde amnesia. I guess so... (didnt get any reference)????????

7. In cases of head injury post-traumatic amnesia of more than 24hrs suggest severe injury. TRUE

8 . In cases of head injury retrograde amnesia is a valid and valuable guide to the severity of head injury. FALSE (Although NOTP gives it in the column on pg 441, the text says that it is not very useful.

9. In cases of head injury retrograde amnesia is longer than post-traumtic amnesia. (dont know)....?????

10. In cases of head injury post-traumatic amnesia is longer than a week leads to severe handicaps. TRUE  

There is a Lishman reference :  PTA > 24 hrs - some permanent disability

PTA < 1hour - return to work in a month

PTA < 1 week - return to work in 4 months

PTA > 1 week - predicts invalidism for a year and 50 - 60% chance of severe psychiatric and intellectual disability at 5 years follow up

11. After a five year follow up in penetrating head injury to right cerebral cortex, there is strong evidence that apathy is a significant association ????? I would say true...

Injury to Mesial Frontal lobe is associated with apathy...

12.After open head injury at least 5% of patients suffer ENT bleeding???? dont know no reference..

13.In cases of head injury CT is more useful than MRI in assessing injury. FALSE MRI is the choice; especially to detect damage to brain tissue (NOTP)

14.In severe head injury blood is mostly found in CSF.?????

15.In severe closed head injury the Glasgow coma scale suggests outcome. TRUE

16.In cases of head injury the EEG is usually unaffected. FALSE (slowing and alpha attenuation)

17. Head injury is the commonest cause of epilepsy. FALSE (Idiopathic I guess)

18. RTAs are associated with amnesia lasting less than 24 hours are more likely to be associated with epilepsy.

(I thot the the longer the PTA, the greater the chance of seizure, just because the severity of the injury has increased... coma lasting more than 24 hours is definitely an increased risk)

19. In cases of head injury if epileptic fits appear at once they will persist. FALSE (only 25%)

20.In head injury post traumatic epilepsy develops in 25%.

(first week in 2 - 5 % ) and I guess it depends on if it is a closed or penetrating... in penetrating I read it is 30%... but I am not sure

21. In recovery after severe closed head injury, at least 10% of patients suffer from post-traumatic epilepsy. ???????

22. In cases of head injury seizures occurring immediately predict a poor prognosis for long term epilepsy.

TRUE.... there is a greater chance of developing late (25%) seizures when compared to those who did not have an early seizure (3%) Seminars...

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23. In cases of head injury the actual injury may be remote to site of impact. TRUE (Coup and Contre coup)

24.In cases of head injury constitutional predisposition is important in the development of post-concussional syndrome. I would say TRUE

(dont know what is meant by constitutional predisposition) but... Increased age, women, previous h/o head injury and substance alcohol use, previous psychopathology.... all increase risk of PCS

25. In Post-concussion syndrome anxiety is increased. TRUE

26. In Post-concussion syndrome depression is rare in mild head injury. FALSE (it is seen in hig rates) There is no correlation between the severity of TBI and PCS

27.In Post-concussion syndrome depression is commoner in the early stages compared to the later stages. TRUE atleast DSM 4 says shortly after the trauma Seminars say after 14 days...

28. In Post-concussion syndrome hypersensitivity to sound develops. TRUE Seminars

29.In Post-concussion syndrome maximum improvement occurs after the first 6 months. FALSE... Most people improve within 3 months...

30. In post-concussion syndrome, the psychological symptoms are increased in first 6 months.

FALSE... In most cases, they improve over the first 3 months...

39. In post-concussion syndrome, the symptoms characteristically fluctuate.????? could not find reference...

40. In post-concussion syndrome litigation tendency is typical. (I dont know if it is typical...) But litigation is more associated with PCS

41. In cases of head injury premorbid personality is important in the development of post concussional syndrome. TRUE

42. In severe head injury damage is prevented if the head was in a fixed position. FALSE

44. Punch-drunk syndrome is characterised by forgetfulness. TRUE

45. Punch-drunk syndrome is characterised by dysarthria. TRUE

46.Punch-drunk syndrome is characterised by shuffling unsteady gait. TRUE

47.Punch-drunk syndrome is characterised by fast activity on EEG. FALSE ( It could be normal or show slowing)

Ref: Greg McLatchie; Neil Brooks. Clinical Neurological examination, neuropsychology, electroencephalography and computed tomographic head scanning in active amateur boxers. J Neurol Neurosurg Psychiatry 1987; 50:96-9.

48. Punch-drunk syndrome is characterised by thickening of corpus callosum on pathological examination. ?????????????????? no ref on thickening (MRI shows attenuation of CC) (I dont think it is thickening; its probably atrophy)

49. In severe closed head injury recovery may continue for 2 years. TRUE

Rapid over first 6 months; slower recovery ovver next 18 months; after 2 years, recovery is due to adjustment and compensation... Very little recovery after 5 years...

52. Apathy is a common sequel of severe head injuries TRUE

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51. In severe closed head injury CSF rhinorrhea occurs in more than 10% FALSE ( emedicine says it is only 1 to 3 %)

52. Reduced tolerance to alcohol is a common consequence of minor head injury. ????? Alcohol dependence worsens often (NOTP)

53. In cases of head injury cognitive impairment is the most common psychiatric disturbance. TRUE

54. Progressive dementia is a recognised sequel of severe closed head injury. TRUE It is recognised.. Accelerated cognitive decline has been found and reduced reserve make the brain vulnerable to effects of aging; Association between head injury and AD has been shown

55. Dizziness is a common consequence of minor head injury. True

56. Emotional lability is a common sequel of severe head injuries. True

57. Epilepsy is a common consequence of minor head injury. False (it is not common)58. Head injury is the commonest cause of epilepsy. False

59. A penetrating right sided head injury is likely to produce prosopagnosia It is not likely... but it can produce... Occipito temporal area involving the fusiform gyrus...

60. Gait disturbances is a common consequence of minor head injury.???? it is seen but i dont know if it is common... Balance problems (Seminars)

61. In severe head injury, headaches are an invariable sequel. TRUE

62. Head injury commonly leads to manic states. (It is not common) 9%

63. Head injury may precipitate manic-depressive psychosis. TRUE

64.Neurotic symptoms are common sequel of severe head injuries. TRUE

65. In cases of head injury repeated trauma may result in a parkinsonian picture. TRUE

66. Personality changes are common sequel of severe head injuries. TRUE

67. In cases of head injury psychiatric sequel is commoner in children than adults. FALSE... possibily due to greater potential for plasticity

68. Psychoses are common sequel of severe head injuries. (not common 2-5%)

69. Head injury can precipitate schizophrenic psychosis. TRUE (2.5% according to Seminars)

70. In cases of head injury schizophrenia develops more often than would be expected by chance.  { The question is just confusing.... Schizophrenia???????? if they consider birth trauma as head injury... possibly... }

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