#5. Concussion

Question 1

An injury that results in complex pathophysiological process affecting the brain; a functional or microstructural injury to neural tissue.

Answer 1

concussion

Question 2

“physical changes not evident on standard imaging but with new technology (DTI, fMRI, ect) we can see signs of axonal injury”

Answer 2

microstructural injuries

Question 3

Neuronal disruption - Acute phase (0-10 days post injury):

• increase in _____ levels
• decreased ______ _______
• Cells cannot repair until ____ normalizes

Answer 3

calcium; oxidative metabolism; Calcium

Question 4

Neuronal Disruption - Persistent Phase:

• _____ damage
• Cell death if ___ levels remain elevated
• _____ metabolism can be decreased for up to a month

Answer 4

axonal; Calcium; glucose

Question 5

3 categories of concussion signs and symptoms?

Answer 5

somatic (physical body), cognitive, neurobehavioral

Question 6

When is the best time to do the first SCAT?

Answer 6

before any injury occurs so you can get a good baseline reading.

Question 7

Sign vs symptom?

Answer 7

Sign - something you can see

Symptom - something the patient tells you about

Question 8

Examples of somatic concussion signs? (6)

Answer 8

• headache
• nausea/vomiting
• sensitivity to light
• sensitivity to sound/noise
• numbing or tingling
• balance and/or coordination problems

Question 9

Examples of cognitive concussion signs? (4)

Answer 9

• feeling slowed down
• feeling in a ‘fog’
• difficulty concentrating
• difficulty remembering

Question 10

Examples of neurobehavioral concussion signs? (6)

Answer 10

• sleeping more or trouble sleeping
• drowsy
• fatigue
• sadness/depression
• nervousness
• irritable

Question 11

“when an athlete suffers a second concussion before the first has fully resolved; results very but can be catastrophic”

Answer 11

secondary impact syndrome

Question 12

Time that it takes to heal a concussion goes up _____ if you get another before the last one fully heals.

Answer 12

exponentially; 2 months –> 4 months –> 8 months –> 16 months –> 32 months

Question 13

6 steps for when a concussion occurs?

Answer 13

1. Remove from play ASAP
2. Inform coaching staff you are removing them
3. Perform SCAT - wait 15 min for player to calm down
4. Refer for medical follow up
5. Ensure they have a safe ride home
6. Document injury

Question 14

Three most common sideline assessment tools for concussion testing?

Answer 14

SCAT, King-Devick, ImPact

Question 15

RTP protocol are started once an athlete is ____.

Answer 15

asymptomatic

Question 16

The 6 steps in the RTP protocol each take how long? If any S&S appear during a phase what happens?

Answer 16

24 hours; the athlete must rest for 24 hours and try the previous stage

Question 17

Research shows that ___ % of concussion cases return to sport too soon and ___ % return to school to soon.

Answer 17

43.5; 44.7

Question 18

What does SCAT stand for?

Answer 18

Sport Concussion Assessment Tool