Traumatic Brain Injury
A description and criteria for Traumatic Brain Injury using DSM-IV-TR According to the Center for Disease Control, a traumatic brain injury (TBI) occurs when an individual sustains a jolt to his head or a piercing head damage that interrupts the functions of human brain. The degree of TBI varies from mild to traumatic. Mild TBI occurs when a person loses consciousness for a short period. Traumatic TBI on the other hand occurs when an individual experiences long-term period of unconsciousness that normally lead to amnesia. TBI can lead to a number of temporary and lasting emotional and behavioral regulation problems (Niehuser, 2009). According to the DSM-IV-TR criteria, symptoms of TBI include dizziness, headache, blurred vision, lightheadedness, fatigue, alteration in sleeping patterns, ringing in the ears and mood swings (Niehuser, 2009). TBI is catalogued according to the severity and mechanism of the damage. There are three types of TBI: mild; moderate; and severe. Some indicators of mild TBI are: short-term loss of consciousnesses; memory loss; eyes open; headache; disorientation; and brief spells of confusion. Symptoms of moderate TBI include: incidences of brain inflammation or bleeding causing drowsiness; eyes open to stimulation; sluggishness; and spells of unconsciousness that last between 30 minutes to six hours. During severe TBI, the victim losses consciousness for more than six hours and cannot open eyes, even when provoked.
The present Diagnostic and Statistical Manual (DSM-IV-TR) has a partial classification structure with regard to the description of mild, moderate or traumatic TBI. Glasgow Coma Scale (GCS) is one of the frequently used severity classification systems to determine the degree of TBI. The GCS scale is normally used for the preliminary assessment of TBI severity. It is an experimental prognostic pointer and helps in early assessment of the severity of brain damage. In Mary’s case, the GCS scale could have been used to determine whether she received any initial resuscitative measures by the poolside. The GCS can be used to ascertain if Mary had any prior history of head injury. The GCS scale consists of simple form with yes/no/unknown content responses that the nurse could use to determine the severity of TBI experienced by Mary (Ara &Bhat, 2010). The medical severity of intracranial damages is shown by the level of consciousness, determined by the GCS scale. In many cases, there is a close affinity between a low GCS score and poorer outcome. In patient with severe TBI, the motor element of the GCS has the most prognostic value since the eye and verbal response in these patients is usually missing. However, in Mary’s case, the predictive value of the eye and verbal elements of the GCS scale was significant because she was able to respond to verbal and tactile stimuli. She was also able to look at the nurses and moved her finger upon request. Thus, the predictive value of the eye and verbal components of GCS is relevant in Mary’s case because she was able to obey instructions from the nurse (Lingsma & Roozenbeek, 2010). Several methods are used to evaluate levels of intellectual functioning. To determine level of intellectual capability, most neuropsychologists utilize the WAIS-IV assessment tools that allow patients (like Mary) to carry on with subtest despite giving successive incorrect answers. The WAIS-IV can thus be used to give adequate information concerning Mary’s cognitive abilities. TBI is usually characterized by memory loss. The WAIS-IV scale can be used to assess memory loss in Mary’s case. The WAIS-IV scale was modified from WAIS-III since clinicians usually assess memory loss and intellectual capability simultaneously. The WAIS-IV subset scores are merged into eight primary indexes that can be used in Mary’s case to test a series of memory functioning such as immediate memory, visual immediate, auditory immediate, auditory...
References: Ara, A. & Bhat, I. (2010). Traumatic Brain Injury; Case experience as a model for
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Lingsma, HF & Roozenbeek, B. (2010). Early prognosis in traumatic injury: from prophesies to
Niehuser, A. (2009). The Defense Rests: Attorney Recognition of Symptoms of Brain Injury.
Retrieved May 17, 2011, from: http://commons.pacificu.edu
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