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Neuro 1 > Concussion > Flashcards

Concussion Flashcards

1
Q

a concussion is what type of injury?

A

metabolic

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2
Q

with a concussion you get increased energy demand + decreased blood supply which results in what?

A

metabolic crisis

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3
Q

what is there an increased energy demand in the neuron following a concussion?

A

the Na/K ATP-dependent pump increases membrane pumping to re-establish balance which depletes the energy stores, leading to an increased demand of energy

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4
Q

what are the subtypes of concussion

A 
vestibular
ocular
cognitive/fatigue
post-traumatic migraine
cervical
anxiety/mood
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5
Q

which subtype is seen more early on following a concussion?

A

cognitive/fatigue

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6
Q

symptoms of cognitive/fatigue subtype

A
  • intense fatigue
  • HA w/ cognitive & physical ac`tivity
  • “end of day” symptoms
  • sleep disturbances
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7
Q

cognitive/fatigue subtype exam findings for a vestibular/ocular screening

A

should be normal

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8
Q

cognitive/fatigue subtype exam findings for a neurocog test

A
  • mild global/widespread deficits across all composites

- deficits with retrieval, encoding intact

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9
Q

what kind of treatment would you do for cognitive/fatigue subtype

A
  • physical/cognitive breaks (NOT naps)
  • pharmacological options (neurostimulants, sleep aide)
  • cognitive therapy
  • monitored, structured exercise progression
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10
Q

ocular/visual subtype risk factors

A

personal/family hx of ocular dysfunction

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11
Q

ocular/visual subtype symptoms

A 
frontal HA driven by visual work 
difficulties with visually-based classes, assignments or activites 
pressure behind eyes
visual "focus" issues 
blurry vision
double vision
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12
Q

ocular/visual subtype exam findings for vision/oculomotor exam

A
  • potentially may see + smooth pursuit & saccades
  • convergence difficulties
  • accomodative insufficiency
  • strabismus
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13
Q

ocular/visual subtype exam findings for neurocog test results

A
  • deficits in reaction time

- deficits with visual memory

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14
Q

convergence

A

ability of eyes to turn inward to focus on a near target

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15
Q

divergence

A

ability of eyes to move outwards to focus on a further target

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16
Q

general symptoms of vergence dysfunction

A
  • intermittent/constant double vision
  • asthenopia when reading (eye strain)
  • frontal HA
  • letters appear to float/move on page
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17
Q

what are common vergence problems

A
  • convergence insufficiency
  • convergence excess
  • convergence spasm
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18
Q

accomodation

A

adjustment of the optics of the eye to keep an object in focus on the retina as its distance from the eye varies

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19
Q

accommodative dysfunction will look like

A
  • reduction in ability to focus at near
  • accomodative spasm
  • struggle to coordinate accommodation and vergence, leading in spatial awareness
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20
Q

ocular/visual subtype treatment

A

ocular motor training

physical exertion is ok

21
Q

vestibular subtype risk factors

A

PMHx of car sickness/motion sensitivity
migraine
anxiety

22
Q

vestibular subtype symptoms

A 
vertigo
dizziness
nausea
overwhelmed in visually-stimulating environments 
balance impairments
23
Q

what symptoms is the biggest complaint post concussion

A

dizziness - 55-80%

24
Q

S/S of vestibular dysfunction

A 
dizziness
blurry vision
nystagmus
tinnitus
vertigo
hearing loss
loss of balance/falls
broad based stance 
sweating, N/V
25
Q

vestibular subtype exam findings for a vestibular/ocular screen

A

VOR dysfunction
VOR suppression
+ smooth pursuit, saccades

26
Q

vestibular subtype exam findings for a neurocog test result

A

difficulty with visual motor speed, rxn time

coexists with migraine and/or anxiety subtypes

27
Q

vestibular subtype treatment

A

vestibular rehab

pharmacological

28
Q

anxiety/mood subtype risk factors

A

personal/family hx of anxiety, migraine, vestibular disorders

29
Q

anxiety/mood subtype symptoms

A 
ruminative thoughts
hyper-vigilant
fastidious 
easily overwhelmed
difficulties initiating/maintaining sleep
30
Q

anxiety/mood subtype exam findings?

A

vestibular - normal

neurocog - normal

31
Q

anxiety/mood subtype treatment

A 
psychotherapy
treat other subtypes if present
structured training
cog behavior training
regulated schedule 
meds
32
Q

post traumatic migraine subtype risk factors

A

personal or family hx of migraine, “ice cream HA,” motion sensitivity, vestibular disorder, anxiety

33
Q

post traumatic migraine subtype symptoms

A

variable HA
nausea, photo and/or phonophobia
stress, anxiety, lack of exercises
sleep dysregulation

34
Q

when do you see photosensitivity

A

post traumatic migraine

35
Q

what is a migraine

A

neurovascular event

failure of central modulation of trigeminovascular system

36
Q

how many pt will experience a preceding aura with a post traumatic migraine

A

1/3

37
Q

post traumatic migraine exam findings for vestibular/ocular screens

A

normal

38
Q

post traumatic migraine exam findings for neurocog test results

A

verbal and visual memory deficits

39
Q

post traumatic migraine treatment

A

meds
diet
stress management
avoid triggers

40
Q

cervical subtype risk factors

A

prior c-spine injury
high velocity injury
strong rotational component to injury

41
Q

cervical subtype symptoms

A

neck pain, stiffness, soreness

HA radiating forward from upper cervical spine

42
Q

cervical subtype exam findings

A

all normal except + cervical screen

43
Q

cervical subtype treatment

A 
imaging
cervical stabilization exercises
meds
injection/nerve block
massage, acupuncture
44
Q

what are the top 10 most reported symptoms in post concussive athletes in order from most to least

A 
HA
feeling slowed down
difficulty concentrating
dizzy
fogginess
fatigue
visual blurring/double vision
light sensitivity 
memory dysfunction
balance probs
45
Q

when do you start seeing recovery

A

80-90% within first 10-14 days

46
Q

how long would full recovery take

A

21-28 days

47
Q

recovery from sports related injury in adolescents takes how long

A

4 weeks

48
Q

what aids in return to sport without prolonged sequelae

A

early identification of impairments

49
Q

what are 6 predictors of prolonged recovery

A 
initial symptoms
sex - female
age 
loss of consciousness
post traumatic amnesia
premorbid comorbidities

Neuro 1 (21 decks)

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