Traumatic brain injury physical examination
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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.