Injury severity

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In NSW there are two common ways of prospectively measuring the severity of TBI.

  • The level of responsiveness and duration of unconsciousness (coma) as measured by the Glasgow Coma Scale.16
  • Duration of post-traumatic amnesia (PTA), evidenced by a period during which the person is disorientated, unable to learn and the inability to know time, place or person (self).

The impact of the injury on the brain determines severity and ranges from concussion to persistent vegetative states and is typically classified from mild to very severe.

The Glasgow Coma Scale is a most useful tool for guiding medical and surgical interventions in the acute phase following injury. The duration of PTA is a most useful tool for determining the outcome following TBI for the individual. People with severe and very severe TBI usually require specialist brain injury rehabilitation.

Mild TBI

A mild TBI is also called a concussion. Most people with mild TBI make a good physical recovery within days, weeks or months. Some experience ongoing problems with living and learning (mild-complicated TBI).

Moderate TBI

About one third of people with a moderate brain injury experience some lifelong problems in functioning.

Severe TBI

Ninety percent of people with a severe brain injury experience lifelong problems in functioning.

Very severe TBI

100% of people with a severe brain injury experience lifelong problems in functioning.

The Care and Needs Scale and Paediatric Care and Needs Scale provides validated tools to measure the level of impact on different domains of functioning after TBI and the hours of support required to maximise participation and minimise disability.56,57

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