Presentations
- Sequelae of acquired brain injury (ABI), such as:
- behavioural
- cognitive
- medical
- physical
- psychosocial
- sensory
Conditions
- Non-traumatic brain injury, such as:
- arteriovenous malformation
- hemispherectomy
- hypoxic brain injury
- immune conditions
- infections
- metabolic disorders
- stroke
- tumour
- Traumatic brain injury (TBI), such as:
- concussion
- mild
- moderate
- severe
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Sequelae of acquired brain injury, such as prolonged disorders of consciousness
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
- Definitions of ABI and TBI, including measures of severity
- Epidemiology and pathophysiology of ABI and TBI
- Factors that affect the trajectory of recovery and disability after brain injury
- Outcomes of ABI versus TBI
- Post-traumatic amnesia, such as:
- clinical management
- methods of measurement
- significance regarding rehabilitation management and outcome
Clinical assessment tools
- Assessment of post-traumatic amnesia, such as Westmead post-traumatic amnesia (PTA) scale
- Clinical psychology assessments
- Common neuropsychological tests of domains, such as:
- adaptive function
- attention and concentration
- executive function
- intellectual function
- Glasgow Coma Scale
- Rancho Los Amigos Scale
- Speech and language assessments
- Vestibular tests
- Vision / Visual perception / Visuomotor integration tests
Investigations
- Cerebral imaging, such as:
- angiogram
- CT
- magnetic resonance angiography (MRA)
- MRI
- Medical imaging to assess sequelae of brain injury, such as video fluoroscopic swallow assessment
Procedures
- Common neurosurgical procedures, such as:
- craniectomy
- external ventricular drain
- intracranial pressure monitoring
- ventriculoperitoneal (VP) shunt
- Spasticity and movement disorder management
Acute management
- Acute monitoring in acute neurosurgical care, emergency, and intensive care
- Pharmacotherapy, including prophylactic anticonvulsant medication
- PTA
- Role of diagnostic investigations in management and prognosis
- Role of paediatric rehabilitation medicine physician in acute neurosurgical and intensive care units
Complications of brain injuries – diagnosis and management
- Aspiration pneumonia
- Associated neuroendocrine disorders / pituitary dysfunction
- Autonomic dysfunction syndrome, including paroxysmal sympathetic hyperactivity
- Behavioural disturbance
- Contractures
- Fatigue and sleep disorders – altered sleep
- Headache
- Heterotopic ossification
- Hypertonicity and movement disorders
- Pain syndrome:
- Post-traumatic hydrocephalus and VP shunting
- Pressure areas
- Psychiatric disorders, such as:
- alcohol and substance issues
- mood disorders
- post-traumatic stress disorder (PTSD)
- psychosis
- suicidality
- Repeat brain injury during recovery phase
- Seizures and epilepsy
- Venous thromboembolism
- Visual disturbances, such as:
- changes in visual acuity and fields
- cortical visual impairment (CVI)
Concussion
- Acute management
- Management of persistent symptoms, such as:
- behavioural and emotional challenges
- headaches
- sleep and fatigue
- vestibular and visual disturbance
- Return to school and sport
Longer term management
- Activities of daily living
- Adjustment and grief
- Assessment and management of symptoms, such as:
- attention
- concentration
- executive function
- intellectual disability
- memory
- Behaviour
- Cognitive disorders
- Communication disorders
- Community reintegration
- Driving
- Fatigue and sleep
- Growth and nutrition, such as obesity
- Pharmacotherapy
- Physical function and impact of:
- balance
- contracture
- movement disorders
- spasticity
- vestibular
- weakness
- Play and leisure
- School reintegration and long-term educational support
- Sexuality and relationships
- Social skills
- Vocational guidance
Prevention of brain injuries
- pool fencing
- road laws, including those relating to car seats and bicycle helmets
- sporting guidelines
