After falling, a patient's Glasgow Coma Scale (GCS) was 5 initially and 7 after 1 day. The pa-tient remained unconscious for 2 weeks but is now awake, confused, and experiencing antero-grade amnesia. This history supports which medical diagnosis?
a. Mild diffuse brain injury
b. Moderate diffuse brain injury
c. Severe diffuse brain injury
d. Postconcussive syndrome
ANS: B
In moderate diffuse axonal injury, the score on the GCS is 4-8 initially and 6-8 by 24 hours, and the person is confused and suffers a long period of posttraumatic anterograde and retrograde amnesia. In mild diffuse axonal injury, coma lasts 6-24 hours, with 30% of persons displaying decerebrate or decorticate posturing. They may experience prolonged periods of stupor or rest-lessness. In severe diffuse axonal injury, the person experiences immediate autonomic dysfunc-tion that disappears in a few weeks. Increased ICP appears 4-6 days after the injury. In postcon-cussive syndrome, the individual experiences headache, nervousness or anxiety, irritability, in-somnia, depression, inability to concentrate, forgetfulness, and fatigability.
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