Concussion Flashcards

1
Q

What is a concussion?

A

A traumatic brain injury, in which a rapid acceleration applied to the cranium results in a force which needs to be dissipated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the pathophysiology of concussion

A
  1. Trauma causes axonal stretch injury due to breaking of microtubules, forming undulations
  2. This causes accumulation of transport proteins
  3. This causes massive Na+ and Ca2+ influx, leading to signalling disruption and depolymerisation of the cytoskeleton
  4. Binding of glutamate to MNDA receptors causes further depolarisation
  5. Na/K pump goes into overdrive to correct this, which uses up ATP, requiring massive amounts of glucose
  6. Glucose hyper metabolism and decreased blood flow due to injury causes metabolic depression in neurones
  7. Persistent Ca2+ excess also inhibits mitochondria, worsening the energy crisis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What symptoms can arise from frontal lobe impairment?

A

Defects with:
Behaviour, emotions, initiation of movement, speech planning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What symptoms can arise from temporal lobe impairment?

A

Defects with:
Language, memory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What symptoms can arise from parietal lobe impairment?

A

Defects with:
Special senses, reading, writing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What symptoms can arise from occipital lobe impairment?

A

Defects with:
Visual, perception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What symptoms can arise from cerebellar impairment?

A

Defects with:
Balance, coordination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some physical signs and symptoms of concussion in adults?

A
  • Headache
  • Dizziness/unsteadiness (Seeing stars)
  • Buzzing in the ears
  • Nausea and vomiting
  • Fatigue or drowsiness
  • Blurred vision
  • Confusion, brain fog
  • Amnesia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some delated symptoms (Hours to days) following concussion?

A
  • Concentration or memory complaints
  • Irritability or personality changes
  • Photosensitivity or photosensitivity
  • Sleep disturbances
  • Parosmia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some symptoms of concussion in children?

A
  • Dazed look
  • Listlessness
  • Irritability
  • Unsteadiness
  • Excessive crying
  • Change in eating or sleeping habits
  • Vomiting
  • Seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are some signs of concussion?

A
  • Temporary loss of consciousness
  • Dysarthria
  • Slow responses
  • Dazed look
  • Forgetfulness
  • Moro and asymetric tonic neck reflex (Fencer position)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the moro reflex?

A

Baby when on back will raise arms into the air above the head (Commonly seen in sports injury)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the asymmetric tonic neck reflex?

A

Baby when on back with put arms in a fencer position to prevent rolling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When do childhood reflexes usually last until?

A

They usually last for the first 2 months, but will often return in concussion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are some factors that affect recovery time from concussion?

A
  • Degree of initial event
  • Number of episodes
  • Gender:
    • Greater degree of impairment
    • Hormonal factors
    • Greater degree of whip-lash type injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How long does resolution of the axonal stretch injury cascade usually take?

A

2-4 weeks

17
Q

What is 2nd impact syndrome?

A

The 2nd episode may be minor with no loss of consciousness, however there will be depressed regulatory fractures and can lead to potentially fatal cerebral oedema

18
Q

What is dementia pugilistica?

A

A chronic traumatic encephalopathy occurring commonly in boxers in which chronic trauma to the head causes neurofibrillary tangles and possible amyloid plaque formation

19
Q

What are the 6 stages of graduated return to play?

A
20
Q

What are the time frames for graduated return to play in adults and children?

A
21
Q

In what type of sporting event is a head injury assessment performed?

A

Elite games only

22
Q

What are the 3 stages of head injury assessment?

A
  • Stage 1 – game day assessment using the HIA1 Form.
  • Stage 2 – post-game, same day assessment using HIA2 Form.
  • Stage 3 – 36-48-hour post-injury assessment using HIA3 Form
23
Q
A