Traumatic brain injury physical examination: Difference between revisions
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Physical examination is the most important, first most, inexpensive, and quick component of the assessment of a patient with traumatic brain injury. This includes vital signs, general examination, cardiopulmonary examination, general trauma survey of the whole body and most importantly neurologic examination. The neurologic exam of a traumatic brain injury patient includes the following key components. | Physical examination is the most important, first most, inexpensive, and quick component of the assessment of a patient with traumatic brain injury. This includes vital signs, general examination, cardiopulmonary examination, general trauma survey of the whole body and most importantly neurologic examination. The neurologic exam of a traumatic brain injury patient includes the following key components. | ||
* Level of consciousness, | |||
* [[Glasgow Coma Scale|GCS]] | |||
* [[Frontal lobe|Higher]] function | |||
* [[Cranial nerve examination]] | |||
* [[Motor Control|Motor examination]] | |||
* [[Sensory Neuroscience|Sensory]] examination | |||
* Examination of [[Cerebellum|cerebellar]] function and [[Gait (human)|gait]] | |||
==Physical Exams== | ==Physical Exams== | ||
Common physical examination findings of traumatic brain injury include<ref name="pmid29083790">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=29083790 | doi= | pmc= | url= }} </ref> | Common physical examination findings of traumatic brain injury include<ref name="pmid29083790">{{cite journal| author=| title=StatPearls | journal= | year= 2020 | volume= | issue= | pages= | pmid=29083790 | doi= | pmc= | url= }} </ref> | ||
*Signs of physical trauma to the skull. | *Signs of physical trauma to the skull. | ||
*[[Neurological examination|Neurologic deficit]] | *[[Neurological examination|Neurologic deficit]] | ||
**[[Motor coordination|Motor]] and sensory skills | **[[Motor coordination|Motor]] and sensory skills | ||
**[[Hearing]] and [[speech]] | **[[Hearing]] and [[speech]] | ||
**[[Motor coordination|Coordination]] and [[Balance disorder|balance]] | **[[Motor coordination|Coordination]] and [[Balance disorder|balance]] | ||
**[[Mental status examination|Mental status]] | **[[Mental status examination|Mental status]] | ||
**[[Mood]] or [[behavior]] changes | **[[Mood]] or [[behavior]] changes | ||
*Normal to abnormal [[Glasgow Coma Scale]] (GCS). GCS is considered to be the best single predictor of good or bad outcome following penetrating head injury. [[Survival rate]] is 0-8.1%, 35.6% and 90.5% for GCS scores of 3-5, 6-8 and 9-15 respectively | *Normal to abnormal [[Glasgow Coma Scale]] (GCS). GCS is considered to be the best single predictor of good or bad outcome following penetrating head injury. [[Survival rate]] is 0-8.1%, 35.6% and 90.5% for GCS scores of 3-5, 6-8 and 9-15 respectively | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Joanna Ekabua, M.D. [2]
Overview
Physical examination is the most important, first most, inexpensive, and quick component of the assessment of a patient with traumatic brain injury. This includes vital signs, general examination, cardiopulmonary examination, general trauma survey of the whole body and most importantly neurologic examination. The neurologic exam of a traumatic brain injury patient includes the following key components.
- Level of consciousness,
- GCS
- Higher function
- Cranial nerve examination
- Motor examination
- Sensory examination
- Examination of cerebellar function and gait
Physical Exams
Common physical examination findings of traumatic brain injury include[1]
- Signs of physical trauma to the skull.
- Neurologic deficit
- Motor and sensory skills
- Hearing and speech
- Coordination and balance
- Mental status
- Mood or behavior changes
- Normal to abnormal Glasgow Coma Scale (GCS). GCS is considered to be the best single predictor of good or bad outcome following penetrating head injury. Survival rate is 0-8.1%, 35.6% and 90.5% for GCS scores of 3-5, 6-8 and 9-15 respectively
- GCS 8-15 and somnolence: Sleepy, easy to wake
- GCS 8-15 and stupor: Hypnoid, hard to wake
- GCS ≥ 13: Mild Head Injury
- GCS 9–12: Moderate Head Injury
- GCS ≤ 8: Severe Head Injury
- GCS 7-8: Light coma; Coma Grade I
- GCS 5-6: Light coma; Coma Grade II
- GCS 4: Deep coma; Coma Grade III
- GCS 3: Deep coma; Coma Grade IV
{{#ev:youtube|FihnmEx6Rqk}} Head injured people with signs of moderate or severe TBI should receive immediate emergency medical attention.