After falling, a patient's Glasgow Coma Scale (GCS) was 5 initially and 7 after 1 day
The patient remained unconscious for 2 weeks but is now awake, confused, and experiencing anterograde 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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