Concussão Flashcards
Qual a classificação da concussão?
Grade 1: Transient confusion, no loss of consciousness (LOC), all symptoms resolve within 15 min. Grade 2: Transient confusion, no LOC, but concussive symptoms or mental status abnormalities persist longer than 15 min. Grade 3: Any LOC, either brief (seconds) or prolonged (minutes).
Como avaliar uma concussão no momento do esporte?
(1) Mental status testing a. Orientation—time, place, person, circumstances of injury b. Concentration—digits backward, months of year in reverse order c. Memory—names of teams, details of contest, recent events, recall of three words and objects at 0 and 5 min
(2) Finger-to-nose with eyes open and closed
(3) Pupillary symmetry and reaction
(4) Romberg and tandem gait
(5) Provocative testing—40-yard sprint, 5 push ups, 5 sit ups, 5 knee bends (development of dizziness, headaches, or other symptoms is abnormal)
Qual o manejo da concussão?
Grade 1: Remove from contest. Examine immediately and at 5-min intervals. May return to contest if exam clears within 15 min. A second grade 1 concussion eliminates player for 1 week, with return contingent upon normal neurologic assessment at rest and with exertion.
Grade 2: Remove from contest, cannot return for at least 1 week. Examine at frequent intervals on sideline. Formal neurologic exam the next day. If headache or other symptoms persist for 1 week or longer, CT or MRI scan is indicated. After 1 full asymptomatic week, repeat neurologic assessment at rest and with exercise before cleared to resume play. A second grade 2 concussion eliminates player for at least 2 weeks following complete resolution of symptoms at rest or with exertion. If imaging shows abnormality, player is removed from play for the season.
Grade 3: Transport by ambulance to emergency department if still unconscious or worrisome signs are present; cervical spine stabilization may be indicated. Neurologic exam and, when indicated, CT or MRI scan will guide subsequent management. Hospital admission indicated when signs of pathology are present or if mental status remains abnormal. If findings are normal at the time of the initial medical evaluation, the athlete may be sent home, but daily exams as an outpatient are indicated. A brief (LOC for seconds) grade 3 concussion eliminates player for 1 week, and a prolonged (LOC for minutes) grade 3 concussion for 2 weeks, following complete resolution of symptoms. A second grade 3 concussion should eliminate player from sports for at least 1 month following resolution of symptoms. Any abnormality on CT or MRI scans should result in termination of the season for the athlete, and return to play at any future time should be discouraged
Quais os três principios sobre lesões associadas em TCE?
Medical personnel caring for head injury patients should be aware that (1) spinal injury often accompanies head injury, and care must be taken in handling the patient to prevent compression of the spinal cord due to instability of the spinal column; (2) intoxication is a common accompaniment of traumatic brain injury and, when appropriate, testing should be carried out for drugs and alcohol; and (3) additional injuries, including rupture of abdominal organs, may produce vascular collapse or respiratory distress that requires immediate attention.
