407 - Traumatic Brain Injuries

| The Surgical Technologist | NOVEMBER 2017 498 and play while also dealing with the effects of TBI. 2 Some 12% of all hospital admissions may be TBI-related, result- ing in that nearly 225 out of every 100,000 people could be affected by some type of TBI in their lifetime. 2 This article will take an in-depth look at TBIs and give the reader useful information about common symptoms and behavioral actions of those with head injuries. W H A T I S T B I ? A TBI is not simply brain damage. A useful, legal definition is found within the Individuals With Disabilities Educa- tion Act of 1990 (as amended). In that law, traumatic brain injury is defined as: “An acquired injury to the brain caused by an external physical force resulting in total or partial functional disability or psychosocial impairment, or both, that adversely affects a child’s educational performance. The term applies to open or closed head injuries result- ing in impairments in one or more areas, such as cognition; language; memory; attention; rea- soning; abstract thinking; judgment; problem- solving; sensory, perceptual and motor abilities; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to brain injuries that are con- genital or degenerative, or are caused by birth trauma.” 2 For the purpose of this article, frontotemporal closed head injuries will be discussed. B R A I N M E M B R A N E R E V I E W The human brain lies within the cranium, or skull, and is surrounded by three distinct membranes that serve to nourish and protect the brain. From outer to inner layer they appear as: dura mater, the dura mater, the arachnoid mater and the and the pia mater. The dura mater is the tough, thick exterior layer, and serves to protect the brain and keep the brain tissues in place. Its thin, outer layer serves as the cranium’s perios- teal membrane, similar to any other bone. The dura’s tough, inner layer serves as the structural support for the capillar- ies, which eventually descend into and nourish the brain. The dura mater also adheres to and follows the convolu- tions of the inner surface of the skull. The arachnoid layer is thinner and more delicate than the dura mater. It is also composed of an outer and inner layer. The outer layer is a fibrous layer, which is in intimate This image shows DAI hyperintensity in opposite hemisphere. Photo courtesyofWayneO’Donal This image shows areas of DAI also clustered on contralateral side, directly across from impact contusion. DAI is also suspected in the left corpus callosum. Photo courtesyofWayneO’Donal