Concussion Flashcards
What is a concussion?
A traumatic brain injury, in which a rapid acceleration applied to the cranium results in a force which needs to be dissipated
Describe the pathophysiology of concussion
- Trauma causes axonal stretch injury due to breaking of microtubules, forming undulations
- This causes accumulation of transport proteins
- This causes massive Na+ and Ca2+ influx, leading to signalling disruption and depolymerisation of the cytoskeleton
- Binding of glutamate to MNDA receptors causes further depolarisation
- Na/K pump goes into overdrive to correct this, which uses up ATP, requiring massive amounts of glucose
- Glucose hyper metabolism and decreased blood flow due to injury causes metabolic depression in neurones
- Persistent Ca2+ excess also inhibits mitochondria, worsening the energy crisis
What symptoms can arise from frontal lobe impairment?
Defects with:
Behaviour, emotions, initiation of movement, speech planning
What symptoms can arise from temporal lobe impairment?
Defects with:
Language, memory
What symptoms can arise from parietal lobe impairment?
Defects with:
Special senses, reading, writing
What symptoms can arise from occipital lobe impairment?
Defects with:
Visual, perception
What symptoms can arise from cerebellar impairment?
Defects with:
Balance, coordination
What are some physical signs and symptoms of concussion in adults?
- Headache
- Dizziness/unsteadiness (Seeing stars)
- Buzzing in the ears
- Nausea and vomiting
- Fatigue or drowsiness
- Blurred vision
- Confusion, brain fog
- Amnesia
What are some delated symptoms (Hours to days) following concussion?
- Concentration or memory complaints
- Irritability or personality changes
- Photosensitivity or photosensitivity
- Sleep disturbances
- Parosmia
What are some symptoms of concussion in children?
- Dazed look
- Listlessness
- Irritability
- Unsteadiness
- Excessive crying
- Change in eating or sleeping habits
- Vomiting
- Seizures
What are some signs of concussion?
- Temporary loss of consciousness
- Dysarthria
- Slow responses
- Dazed look
- Forgetfulness
- Moro and asymetric tonic neck reflex (Fencer position)
What is the moro reflex?
Baby when on back will raise arms into the air above the head (Commonly seen in sports injury)
What is the asymmetric tonic neck reflex?
Baby when on back with put arms in a fencer position to prevent rolling
When do childhood reflexes usually last until?
They usually last for the first 2 months, but will often return in concussion
What are some factors that affect recovery time from concussion?
- Degree of initial event
- Number of episodes
- Gender:
- Greater degree of impairment
- Hormonal factors
- Greater degree of whip-lash type injury