NCS Traumatic Brain Injury 3

Question 1

Diffuse axonal injury (DAI) after TBI is best visualized on which MRI sequence?

Accepted Answer

Susceptibility-weighted imaging (SWI)

Answer

SWI is the most sensitive conventional MRI sequence for detecting microhemorrhages associated with DAI due to its sensitivity to blood products and iron.

Question 2

In the acute management of severe TBI, the Brain Trauma Foundation recommends maintaining cerebral perfusion pressure (CPP) within which range?

Accepted Answer

50–70 mmHg

Answer

The Brain Trauma Foundation guidelines recommend targeting CPP of 60–70 mmHg (50–70 mmHg range accepted) to optimize cerebral blood flow while avoiding secondary injury.

Question 3

Paroxysmal sympathetic hyperactivity (PSH) after severe TBI is characterized by episodic increases in which combination of signs?

Accepted Answer

Heart rate, blood pressure, temperature, sweating, and posturing

Answer

PSH is defined by simultaneous paroxysmal increases in heart rate, blood pressure, temperature, diaphoresis, and tachypnea, often accompanied by extensor posturing.

Question 4

A 30-year-old patient with moderate TBI develops elevated serum sodium (160 mEq/L) with large urine output and low urine osmolality 5 days post-injury. The most likely diagnosis is:

Accepted Answer

Central diabetes insipidus (CDI)

Answer

Central diabetes insipidus results from hypothalamic/pituitary damage causing ADH deficiency, leading to hypernatremia, polyuria, and dilute urine after TBI.

Question 5

The Disorders of Consciousness Scale (DOCS) is designed to assess patients at which level of recovery?

Accepted Answer

Rancho Los Amigos Levels I–III (coma to localized response)

Answer

The DOCS is a standardized scale used with patients in coma or vegetative/minimally conscious states (Rancho Levels I–III) to assess and track sensory responsiveness.

(NCS) Neurologic Clinical Specialist Practice Test

(NCS) Neurologic Clinical Specialist Practice Test

NCS Traumatic Brain Injury 3