Clinical Perspective - Clinical Sports Related Head Trauma Flashcards
What is the mechanism of a concussion?
Rapid acceleration-deceleration of the head due to a direct or indirect injury. Rotational acceleration in the primary mechanism of injury.
Chronic traumatic encephalopathy can only be diagnosed post-mortem. What histologic changes will be seen in a patient with CTE?
Phosphorylated tauopathy in the form of neurofibrillary tangles
What is the mechanism of the Q collar in concussion prevention?
The collar compressed the internal jugular vein to restrict venous outflow from the cerebrum. This causes slight enlargement of the brain that increases turgor and prevents movement
How long must symptoms last for a diagnosis of post-concussion syndrome?
4 weeks
How long does concussion recovery take in most patients?
7-10 days
An individual is rear-ended while stopped at a red light. They are diagnosed with a concussion after being transported to the ER. Is this a (direct/indirect) injury?
Indirect injury
True/False. Indications of a concussion may show on an fMRI.
True. However, a CT and MRI will appear normal, with no structural changes.
What signs warrant immediate removal from sports activity following a traumatic head injury?
Loss of consciousness, seizure, ataxia, confusion, behavioral changes, amnesia
Concussions occur due to rapid acceleration/deceleration of the head. What is the primary mechanism of injury?
Rotational acceleration of the brain
True/False. Anticipation of a collision reduces head acceleration and risk of injury.
True. However, increased neck strength and mass in and of itself is not proven to prevent concussions
What are the limitations of star-rated helmets in concussion prevention?
They do not change the overall energy the brain is exposed to during impact. These helmets reduce impact injuries (skull fracture), but have limited ability to prevent concussions
The on-field assessment involves what steps?
Airway, breathing, circulation, disability (consciousness), cervical injury
What complications (syndromes) may arise from repeated head trauma and/or premature return to normal functioning?
Post-concussion syndrome, chronic traumatic encephalopathy
True/False. Mouthguards are an effective means of preventing concussion due to head injury.
False. Mouthguards have been repeatedly proven to be ineffective in preventing concussions. They only protect teeth.
What is the definition of a sports concussion?
A traumatic brain injury that occurs during sports or exercise-related activity that results in rapid, short-lived impairment of neurological functioning that resolves spontaneously
What is neuropsychological testing?
A standardized test of cognition that creates a baseline for comparison during concussion recovery
True/False. It is recommended that patients take NSAIDs for symptom management following a concussion.
False. Acetaminophen is recommended for the first 48 hours. After this, NSAIDs may be used. There is concern for bleeding if NSAIDs are used immediately following injury
An athlete is approved to return to physical activity gradually. They have no symptoms following cycling and wish to join their team in sprints on the same day. What is the physician’s recommendation to this patient?
The patient cannot participate in sprints. This is a more rigorous form of physical activity. 24 hours must be taken between phases of recovery to ensure symptoms do not reappear
What symptoms should be assessed during the on-field assessment?
Headache, head pressure, nausea, dizziness, photophobia, phonophobia, blurred vision, fogginess, “out of it”, “does not feel right”
A football player is tackled and hits their head forcefully on the ground. This is an example of a (direct/indirect) injury.
Direct injury
Sideline assessment tools for concussion test…?
Symptoms, cognition, neurologic functioning
True/False. The plan for returning to regular functioning is patient-specific.
True. Still, the plan should ALWAYS involve gradual return to activity
