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In order Cuccurullo > Ch 2 - TBI: Mild TBI and Postconcussion syndrome > Flashcards

Ch 2 - TBI: Mild TBI and Postconcussion syndrome Flashcards

1
Q

What is the definition of a mild TBI?

A

Traumatically induced physiological disruption of the brain with at least 1 of the 4 manifestations:

  • Any LOC
  • Loss of memory of event before or after events
  • Any alteration in mental status at time of accident
  • Focal neuro deficits that may or may not be transient
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2
Q

Mild TBI does not exceed the following criteria:

A

– LOC > 30 minutes
– PTA >24 hours
– Initial GCS < 12

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3
Q

What in found on CT/MRI head in mild TBI?

A

Negative radiologic findings

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4
Q

What is the MC symptoms of mild TBI?

A

Headache

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5
Q

When do symptoms recover in mild TBI?

A

First few weeks or months post-injury (usually within 1–3 months).

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6
Q

What is second impact syndrome?

A

Second brain injury before symptoms of prior concussion cleared

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7
Q

What is the DSM-IV criteria for Post-concussion syndrome?

A

A. Hx TBI causing “significant cerebral concussion”
B. Cognitive deficit in attention and/or memory
C. Presence of at least 3 of 8 sx for 3 months

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8
Q

What are the symptoms of post-concussion syndrome?

A 
Fatigue
Sleep disturbance
HA
Dizziness
Irritability
Affective disturbance
Personality change
Apathy
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9
Q

What is persistent post-concussion syndrome?

A

Concussion symptoms lasting over 3 to 6 months

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10
Q

What are different grading scales for concussion?

A

– Colorado Medical Society Guidelines
– American Academy of Neurology (AAN) Guidelines
– Cantu Guidelines

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11
Q

What is a Grade 1-mild TBI based on the Cantu system?

A
  • No LOC

* PTA/PCSS < 30 min

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12
Q

What is a Grade 2-moderate TBI based on the Cantu system?

A
  • LOC < 1 min
  • PTA 30 min–24 hr
  • PCSS 30 min–7 days
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13
Q

What is a Grade 3-severe TBI based on the Cantu system?

A
  • LOC > 1 min
  • PTA > 24 hr
  • PCSS > 7 days
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14
Q

What is a Grade 1-mild TBI based on the Colorado system?

A
  • No LOC

* Confusion < 15 min

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15
Q

What is a Grade 2-moderate TBI based on the Colorado system?

A
  • No LOC

* Confusion > 15 min

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16
Q

What is a Grade 3-severe TBI based on the Colorado system?

A
  • Grade 3a—Brief LOC (sec)

* Grade 3b—Prolonged LOC (min)

17
Q

What are the rules on return to play day of concussion?

A

No return to play regardless of concussion severity

18
Q

What is the first step in concussion management?

A

Physical and cognitive rest until the acute symptoms resolve (usually 24 to 48 hours)

19
Q

What follows rest in concussion management?

A

Stepwise graded program of exertion prior to medical clearance and rereturn to play (RTP)

20
Q

How can an athlete proceed to the next step of the Graduate RTP Protocol?

A

Asymptomatic at the current level and each step takes ~24 hours

21
Q

What happens if an athlete experiences any post-concussive symptoms during graduated RTP protocol?

A

Drop back to the previous asymptomatic level and try to progress again after another 24-hour period of rest has passed

22
Q

What is the first Rehabilitation stage on graduate RTP protocol?

A

No activity

23
Q

What is the functional exercise during the first Rehabilitation stage on graduate RTP protocol?

A

Symptom limited physical and cognitive rest

24
Q

What is the objective of the first Rehabilitation stage on graduate RTP protocol?

A

Recovery

25
Q

What is the second Rehabilitation stage on graduate RTP protocol?

A

Light aerobic exercise

26
Q

What is the functional exercise during the second Rehabilitation stage on graduate RTP protocol?

A

Walking, swimming or stationary cycling keeping intensity <70% maximum permitted heart rate No resistance training

27
Q

What is the objective of the second Rehabilitation stage on graduate RTP protocol?

A

Increase HR

28
Q

What is the third Rehabilitation stage on graduate RTP protocol?

A

Sport-specific exercise

29
Q

What is the functional exercise during the third Rehabilitation stage on graduate RTP protocol?

A

Skating drills in ice hockey, running drills in soccer. No head impact activities

30
Q

What is the objective of the third Rehabilitation stage on graduate RTP protocol?

A

Add movement

31
Q

What is the fourth Rehabilitation stage on graduate RTP protocol?

A

Non-contact training drills

32
Q

What is the functional exercise during the fourth Rehabilitation stage on graduate RTP protocol?

A

Progression to more complex training drills, e.g., passing drills in football and ice hockey May start progressive resistance training

33
Q

What is the objective of the fourth Rehabilitation stage on graduate RTP protocol?

A

Exercise, coordination and cognitive load

34
Q

What is the fifth Rehabilitation stage on graduate RTP protocol?

A

Full-contact practice

35
Q

What is the functional exercise during the fifth Rehabilitation stage on graduate RTP protocol?

A

Following medical clearance participate in normal training activities

36
Q

What is the objective of the fifth Rehabilitation stage on graduate RTP protocol?

A

normal training activities

Restore confidence and assess functional skills by coaching staff

37
Q

What is the sixth Rehabilitation stage on graduate RTP protocol?

A

Return to play

38
Q

What is the functional exercise during the sixth Rehabilitation stage on graduate RTP protocol?

A

Normal game play

In order Cuccurullo (91 decks)

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