SIGNS
ASSESSMENTS
Motor: spasticity, hemiplegia, heterotopic ossification,
tremors, ataxia, decerebrate or decorticate rigidity.
Cognitive: retrograde or anterograde amnesia, impaired
sustained attention, reasoning, memory, and impulse
control.
Psychosocial: Depression, aggression, suicide, PTSD.
The Glasgow Coma Scale (GCS): Predicts mortality and outcomes of
comatose patients.
The Disability Rating Scale (DRS): Assesses quantitative data from eight
categories, including self-care, cognition, and psychosocial skills.
The Level of Cognitive Functioning Scale (LCFS): Classifies patients into
eight levels of cognitive functioning.
POPULATION
1.7 Million Americans are affected annually;
52,000 die, 275,00 are hospitalized, and 90,000
have a lifelong disability. Permanent disability
rates rise with the severity of TBI, mild (10%),
moderate (66%), severe (100%),
Men aged 15 to 24 are at the most significant
risk for TBI. American/Alaskan natives and
African Americans are more prone to have a TBI.
CAUSES
The three leading causes are violence,
falls, and motor vehicle accidents.
Lifespan may be reduced by as long as
nine years. The prognosis depends on
trauma score, GCS score, biomarkers,
length of coma, hypoxia, and duration of
amnesia.
EFFECT ON BADLS
TRAUMATIC
BRAIN
INJURY
Fact sheet
by Pablo
Perez
PRECAUTIONS
Acute phase: Prevent CAUTI (Catheter-associated
urinary tract infections), monitor oxygen saturation levels,
prevent joint deformities, provide sensory stimulation,
prevent DVTs and contractures and protect the head with
helmets.
Atchison, B., & Dirette, D. (2023). Conditions in occupational therapy: Effect on occupational performance
(6th ed.). Lippincott Williams & Wilkins.
Initially, patients on levels one to three of the
LCFS depend on all basic daily living activities. As
they progress through the cognitive levels, they
require less assistance. However, depending
on severity, they may still require supervision
assistance with grooming, toileting, bathing,
dressing, feeding, or transfers even four years
after the onset of TBI.
EFFECT ON WORK
After a TBI, self-awareness is a significant
predictor for obtaining or maintaining
employment. Individuals with TBI have a 50
-70% rate of unemployment. Psychosocial skills
are more important than cognitive or
sensorimotor skills in predicting employment
success. TBI survivors find few opportunities or
low-paying wages, causing them to rely on
public assistance.
EFFECT ON DRIVING
After a traumatic brain injury, the cognitive, visual, and
perceptual skills needed for driving are impaired. In particular,
self-awareness is the most glaring deficit that severely
impacts safety and the ability to problem-solve in real-time
while on the road. What kind of driver would a person be if they
were unaware of a visual field cut, poor attention, or inattention
to one side? 50% of people with moderate to severe TBI drive
again within 5 years.
Level 1: No
response
Level 8:
Purposeful
appropriate
Level 7:
Automatic
appropriate
Level 2:
Generalized
response
Level of Cognitive
Functioning Scale
(LCFS)
Level 6:
ConfusedAppropriate
Atchison, B., & Dirette, D. (2023). Conditions in occupational therapy: Effect
on occupational performance (6th ed.). Lippincott Williams & Wilkins.
Level 5:
ConfusedInappropriate
Level 3:
Localized
response
Level 4:
ConfusedAgitated