Galveston Orientation and Amnesia Test

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Galveston Orientation and Amnesia Test
Medical diagnostics
Purposemeasure of orientation/attention

The Galveston Orientation and Amnesia Test (GOAT) is a measure of attention and orientation, especially to see if a patient has recovered from post-traumatic amnesia (PTA) after a traumatic brain injury. [1] This was the first measure created to test post-traumatic amnesia, and is still the most widely used test. [1] The test was created by Harvey S. Levin and colleagues (1979), and features ten questions that assess temporal and spatial orientation, biographical recall, and memory. [2] Points are awarded for responses to each question, with a 100 points possible. A score greater than 78 for three consecutive days is considered the threshold for emergence from post-traumatic amnesia. [3] This test is intended for patients aged 15 years or older. Younger patients are given a modified version of the test, known as the Children's Orientation and Attention Test (COAT).

Contents

The scores on this test have been found to relate to both the Glasgow Coma Scale and the Glasgow Outcome Scale. [4]

Modified versions

MOAT

A modified version of this test, known as MOAT or Modified GOAT, is a similar questionnaire that assesses memory, orientation, and attention. This modified version has multiple choice options for those who have expressive-language difficulties or who are intubated. Here, a score of greater than 60 for two consecutive days is considered emergence from PTA. [5]

COAT

The Children's Orientation and Attention Test (COAT) is a pediatric version of the test for ages 3–15. [6] This test assesses orientation by asking the child or adolescent to give their first and last names, their parents' names, and to identify their current location. [7]

Related Research Articles

Head injury Serious trauma to the cranium

A head injury is any injury that results in trauma to the skull or brain. The terms traumatic brain injury and head injury are often used interchangeably in the medical literature. Because head injuries cover such a broad scope of injuries, there are many causes—including accidents, falls, physical assault, or traffic accidents—that can cause head injuries.

Brain damage destruction or degeneration of brain cells

Neurotrauma, brain damage or brain injury (BI) is the destruction or degeneration of brain cells. Brain injuries occur due to a wide range of internal and external factors. In general, brain damage refers to significant, undiscriminating trauma-induced damage, while neurotoxicity typically refers to selective, chemically induced neuron damage.

Traumatic brain injury condition caused by an external force which has traumatically injured the brain

Traumatic brain injury (TBI), also known as intracranial injury, occurs when an external force injures the brain. TBI can be classified based on severity, mechanism, or other features. Head injury is a broader category that may involve damage to other structures such as the scalp and skull. TBI can result in physical, cognitive, social, emotional, and behavioral symptoms, and outcome can range from complete recovery to permanent disability or death.

Memory disorders are the result of damage to neuroanatomical structures that hinders the storage, retention and recollection of memories. Memory disorders can be progressive, including Alzheimer's disease, or they can be immediate including disorders resulting from head injury.

Psychogenic amnesia or dissociative amnesia is a memory disorder characterized by sudden retrograde episodic memory loss, said to occur for a period of time ranging from hours to years. More recently, "dissociative amnesia" has been defined as a dissociative disorder "characterized by retrospectively reported memory gaps. These gaps involve an inability to recall personal information, usually of a traumatic or stressful nature." In a change from the DSM-IV to the DSM-5, dissociative fugue is now subsumed under dissociative amnesia.

Post-concussion syndrome (PCS) is a set of symptoms that may continue for weeks, months, or a year or more after a concussion – a mild form of traumatic brain injury (TBI). About 15% of individuals with a history of a single concussion develop persistent symptoms associated with the injury.

The Rancho Los Amigos Scale (RLAS), a.k.a. the Rancho Los Amigos Levels of Cognitive Functioning Scale (LOCF) or Rancho Scale, is a medical scale used to assess individuals after a closed head injury, including traumatic brain injury, based on cognitive and behavioural presentations as they emerge from coma. It is named after the Rancho Los Amigos National Rehabilitation Center, located in Downey, California, United States in Los Angeles County.

Intraventricular hemorrhage

Intraventricular hemorrhage (IVH), also known as intraventricular bleeding, is a bleeding into the brain's ventricular system, where the cerebrospinal fluid is produced and circulates through towards the subarachnoid space. It can result from physical trauma or from hemorrhaging in stroke.

Concussion grading systems are sets of criteria used in sports medicine to determine the severity, or grade, of a concussion, the mildest form of traumatic brain injury. At least 16 such systems exist, and there is little agreement among professionals about which is the best to use. Several of the systems use loss of consciousness and amnesia as the primary determinants of the severity of the concussion.

Post-traumatic amnesia (PTA) is a state of confusion that occurs immediately following a traumatic brain injury (TBI) in which the injured person is disoriented and unable to remember events that occur after the injury. The person may be unable to state their name, where they are, and what time it is. When continuous memory returns, PTA is considered to have resolved. While PTA lasts, new events cannot be stored in the memory. About a third of patients with mild head injury are reported to have "islands of memory", in which the patient can recall only some events. During PTA, the patient's consciousness is "clouded". Because PTA involves confusion in addition to the memory loss typical of amnesia, the term "post-traumatic confusional state" has been proposed as an alternative.

Post-traumatic seizures (PTS) are seizures that result from traumatic brain injury (TBI), brain damage caused by physical trauma. PTS may be a risk factor for post-traumatic epilepsy (PTE), but a person who has a seizure or seizures due to traumatic brain injury does not necessarily have PTE, which is a form of epilepsy, a chronic condition in which seizures occur repeatedly. However, "PTS" and "PTE" may be used interchangeably in medical literature.

Amnesia is a deficit in memory caused by brain damage or disease, but it can also be caused temporarily by the use of various sedatives and hypnotic drugs. The memory can be either wholly or partially lost due to the extent of damage that was caused. There are two main types of amnesia: retrograde amnesia and anterograde amnesia. Retrograde amnesia is the inability to retrieve information that was acquired before a particular date, usually the date of an accident or operation. In some cases the memory loss can extend back decades, while in others the person may lose only a few months of memory. Anterograde amnesia is the inability to transfer new information from the short-term store into the long-term store. People with anterograde amnesia cannot remember things for long periods of time. These two types are not mutually exclusive; both can occur simultaneously.

There are many causes of seizures. The factors that lead to a seizure are often complex and it may not be possible to determine what causes a particular seizure, what causes it to happen at a particular time, or how often seizures occur.

Transitional Learning Center post-acute brain injury rehabilitation facility based in Galveston, Texas

The Transitional Learning Center(TLC) is a post-acute brain injury rehabilitation facility headquartered in the island city of Galveston, Texas. It was started by the non-profit Moody Foundation in 1982, in response to a brain injury suffered by a son of trustee Robert L. Moody. The center provides survivors of acute brain injury with rehabilitation services needed to help patients overcome their injuries and regain independence. In order to provide additional space for post-acute brain injury rehabilitation, in 2008 the center opened a branch facility in Lubbock, Texas, to help serve needs of people throughout the southwest United States. TLC Director of Neuropsychology, Dr. Dennis Zgaljardic, is a past president of the Houston Neuropsychological Society.

Altered level of consciousness measure of arousal other than normal

An altered level of consciousness is any measure of arousal other than normal. Level of consciousness (LOC) is a measurement of a person's arousability and responsiveness to stimuli from the environment. A mildly depressed level of consciousness or alertness may be classed as lethargy; someone in this state can be aroused with little difficulty. People who are obtunded have a more depressed level of consciousness and cannot be fully aroused. Those who are not able to be aroused from a sleep-like state are said to be stuporous. Coma is the inability to make any purposeful response. Scales such as the Glasgow coma scale have been designed to measure the level of consciousness.

The British Columbia Postconcussion Symptom Inventory (BC-PSI), is a 16 item self-report inventory designed to measure both the frequency, and intensity of the ICD-10 criteria for Post concussion syndrome, which is a common occurrence in cases of mild traumatic brain injury. The (BC-PSI) asks the respondent to rate the severity of 13 symptoms rated on a six-point Likert-type rating scale that measures the frequency and intensity of each symptom in the past two weeks.

A sports-related traumatic brain injury is a serious accident which may lead to significant morbidity or mortality. Traumatic brain injury (TBI) in sports are usually a result of physical contact with another person or stationary object, these sports may include boxing, football, field/ice hockey, lacrosse, martial arts, rugby, soccer, wrestling, auto racing, cycling, equestrian, roller blading, skateboarding, skiing, or snowboarding.

Ventricular-brain ratio

Ventricular-brain ratio (VBR), also known as the ventricle-to-brain ratio or ventricle-brain ratio, is the ratio of total ventricle area to total brain area, which can be calculated with planimetry from brain imagining techniques such as CT scans. It is a common measure of ventricular dilation or cerebral atrophy in patients with traumatic brain injury or hydrocephalus ex vacuo. VBR also tends to increase with age.

In electroencephalography, the P50 is an event related potential occurring approximately 50 ms after the presentation of a stimulus, usually an auditory click. The P50 response is used to measure sensory gating, or the reduced neurophysiological response to redundant stimuli.

The Westmead Post-traumatic Amnesia Scale (WPTAS) is a brief bedside standardised test that measures length of post-traumatic amnesia (PTA) in people with traumatic brain injury. It consists of twelve questions that assess orientation to person, place and time, and ability to consistently retain new information from one day to another. It is administered once a day, each and every day, until the patient achieves a perfect score across three consecutive days, after which the individual is deemed to have emerged from post-traumatic amnesia. PTA may be deemed to be over on the first day of a recall of 12 for those who have been in PTA for greater than four weeks. The WPTAS is the most common post-traumatic amnesia scale used in Australia and New Zealand.

References

  1. 1 2 Nathan Zasler; Douglas Katz, MD; Ross D. Zafonte (2007). Brain Injury Medicine: Principles and Practice. Demos Medical Publishing. p. 289. ISBN   978-1-888799-93-4.
  2. Joel A. DeLisa; Bruce M. Gans; Nicholas E. Walsh (2005). Physical Medicine and Rehabilitation: Principles and Practice. Lippincott Williams & Wilkins. pp. 1012–. ISBN   978-0-7817-4130-9.
  3. David X. Cifu, MD; Deborah Caruso, MD (29 April 2010). Traumatic Brain Injury. Demos Medical Publishing. p. 26. ISBN   978-1-933864-61-7.
  4. Robert L. Mapou; Jack Spector (28 February 1995). Clinical Neuropsychological Assessment: A Cognitive Approach. Springer. pp. 188–. ISBN   978-0-306-44869-0.
  5. David X. Cifu, MD; Henry L. Lew (10 September 2013). Handbook of Polytrauma Care and Rehabilitation. Demos Medical Publishing. p. 224. ISBN   978-1-936287-55-0.
  6. Nathan D. Zasler MD; Douglas I. Katz MD; Ross D. Zafonte DO; David B. Arciniegas MD; M. Ross Bullock MD, PHD; Jeffrey S. Kreutzer PHD, ABPP (27 August 2012). Brain Injury Medicine, 2nd Edition: Principles and Practice. Demos Medical Publishing. p. 587. ISBN   978-1-61705-057-2.
  7. Andrew S. Davis PhD (25 October 2010). Handbook of Pediatric Neuropsychology. Springer Publishing Company. p. 613. ISBN   978-0-8261-5737-9.