Concussion Flashcards
Concussion is a form of ….
and is seen as ….
mild traumatic brain injury
functional rather than structural impairment
What can concussion be used to describe
distinct patho entity with its own diagnostic + management
describe a constellation of symptoms tat arise after a TBI
What can concussion be used to describe
distinct patho entity with its own diagnostic + management
describe a constellation of symptoms tat arise after a TBI
What happens as a result of mechanical injury in concussion
indiscriminate release of ntsm
not enough to cause excitotoxicity
what are widespread ionic fluxes and what to they do
ion conc are distorted after concussion
inc activity of mem pumps to restore ionic gradient
K+ in, Na out
brain goes into hyperglycolysis to generate more ATP
describe the neurometabolic cascade following concussion
Low cerebral blood flow immediately after injury for days after
initially increased glucose response, this decreases over the next days
K spikes. Ca2+ inc them decreases slowly
Small peaks in glutamate
can concussion cause axonal injury
yep, in white matter tracts
stretching axons resulting in impaired transport an connectivity
how can you detect mild axonal injury
diffusion tensor imagine (DTI) which measured diffusion of water molecules in tissue
what does DTI do
- reveals flow in line with axon direction
- abnormalities seen with concussion
- integrity white matter tracts = exam connectivity between regions
what is evidence of axonal injury in blood
- axonal proteins eg calpaincleaved α-spectrin N-terminal fragment (SNTF), tau and
neurofilament light chain
=> axon lysis + degeneration
=> non regeneration => thrfr permanent brain damage for some
what’s the current understanding of concussion
Single uncomplicated mild traumatic brain injury
typically results in acute neurocognitive and balance deficits and a rapid (3 to 10 day) recovery curve.
10-15% will have persistent symptoms
what are the risks of repeated concussion
mild tbi = 3-6x more likely for a second
multiple = severe cog impariment, depression, neurodegeneration
children = slow recovery
what’s chronic traumatic encephalopathy features + diagnosis
post mortem diagnosis
pathognomonic lesion = hyperphosphorylated tau aggregates, initially in neurons + astrocytes close bv @ base sulci, later spreading
Cerebral atrophy, thinning of white matter pathways
what’s tau
hyperphosphorylation => detach tau from microtubulues =? destabilisation + inhibit axonal transport
detached tau => nerofibrillary tangles
what is tau pathology
- ptau = restricted to isolated foci in cerebral cortex + locus coeruleus
- multiple ptau lesions in depths cerebral sulci
- ptau path = widespread cortex, amygdala, hippocampus + entorhinal cortex
- widespread severe pathology
