TBI

• TBI is defined by : 

  • it is an alteration in brain structure or function caused by external forces 
  • results in vascular and axonal damage, edema, and neuronal cell death 
  • produces a cascade of pathological events including local neural dysfunction and/or disruption of neural networks 
  • can lead to lifelong impairments and cognitive deficits
• Types of TBI

  • Penetrating
  • Closed
  • Blast
  • Concussion
• Penetrating TBI


  Focal brain lesions produced by the entrance of an external object into the brain, results from projectiles or knife wounds (in civilians) OR blast-related shrapnel or missile injuries (in military)
• What is closed TBI due to ?

  acceleration
• What are the 5 symptoms of TBI ?

  • loss of conciousness
  • loss of memory
  • mental alteration
  • neurological issues
  • intracranial lesion
• The glasgow coma scale goes from 3 to 15, if its small number it is bad
• What tests you can to to see TBI ?

  • balance
  • agility
  • rhythm coordination
  • cognitive deficit
• What are the 3 levels of TBI ?

  • mild
  • moderate
  • severe
• What are the second injuries and what do they involve ?

  • second injuries involve neurobiological stuff
  • increased depolarization
  • increased intracellular calcium = then it can activate free radicals
  • increased degradation and apoptosis
• What treatments can you do for TBI ?

  • quick medical interventions in order to decrease intracranial pressure
  • Improve blood flow
  • benzodizepine to decrease metabolism
  • surgical intervention
  • hypothermia
  • stimulation approach
  • cell therapies
• What are the 4 techniques you can use in TBI ?

  • DBS
  • VNS
  • rTMS
  • tDCS
• What is rTMS ?

  rythmic transcranial magentic stimulation
• Why using VNS and what is it ?

  • VNS is : vagus nerve stimulation
  • It can gave neuroprotective effects and decrease bad stuff
• What are the few behavioral approaches you can use ?

  • rehab
  • physical therapy
  • speech language therapy
  • enriched environements
  • community help
• What are some things they implemented with VR ?

  • VROOM using robotics and multisensory to enhance performance
  • CAREN robotics using cognitive stuff, used by military ppl
  • Non imersive VR
  • physical exercise
  • Robotic neuro rehab
  • Navigation on routes and spatial represntation tests
  • tele rehab = phone stuff
• What do you see in the DMN in TBI ?

  Decrease functional connectivity in DMN BUT increased between DMN and VLPFC
• TBI shows an increased activation of frontal tempo parietal lobes
• After TBI, training reduces redistribution of attentional network
• TBI can result in up regulation of cognitive network