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Neuroscience IV > Concussion > Flashcards

Concussion Flashcards

1
Q

T/F: the majority of concussions are sports related.

A

False. 83.5% non.

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2
Q

What is the typical mechanism of injury for concussion?

A

Acceleration / deceleration

  • blast
  • blow to body
  • blow to head
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3
Q

T/F: With concussion, imaging is abnormal.

A

False, it’s normal.

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4
Q

What is a typical blast wave pressure?

A

100 psi

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5
Q

What environmental aspects make blast injury more damaging?

A
  • closed versus open space
  • in water versus air
  • distance from blast
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6
Q

With mechanical trauma, there is deformation of the cell membrane and neurometabolic changes. Why doesn’t this show up on imaging?

A

Neurons are dysfunctional, not destroyed.

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7
Q

What factors lead to the metabolic crisis and inflammation seen in concussion?

A

Increased energy demand with decreased blood supply.

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8
Q

What does the reticular formation control? Categorize by ascending and descending tracks.

A

ASCENDING

  • Arousal
  • Attention
  • Sleep/wake

DESCENDING

  • Posture
  • Equilibrium
  • Autonomic function
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9
Q

Name 4 risk factors for concussion.

A
  1. Female
  2. Age (younger is greater)
  3. Previous concussion
  4. Level of play (pro is better)
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10
Q

What are the 3 symptoms that PTs treat in concussion?

A
  1. Vestibular
  2. Cervical
  3. Ocular
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11
Q

Of the 4 computer-based neurocognitive tests (Cogsport, Headminders, ANAM, ImPact), which is most accessible and widely used?

A

ImPact.

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12
Q

T/F: An unanticipated blow results in greater severity of concussion?

A

True.

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13
Q

When administering a Vestibular/Ocular Motor Screening for concussion, what do you typically see with saccades and smooth pursuit?

A

Saccadic overshooting and smooth pursuit breakdown.

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14
Q

What is normal convergence (point at which target becomes double)?

A

6-10cm

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15
Q

What do PTs want to examine wrt ocular function after concussion?

A

Convergence
VOR cancellation
CTSIB

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16
Q

Why is the CTSIB used for people with concussion?

A

Sensory integration problems

17
Q

What types of abnormal ocular findings are present with concussion?

A

Gaze-evoked nystagmus

Ocular misalignment

18
Q

Why do we see gaze evoked nystagmus?

A

central, problem with neural integrator

19
Q

Physical therapy examination should include what tests to rule in / out other possible pathology?

A
  1. Dix-Hallpike for BPPV
  2. Cervical Spine Assessment for whiplash, cervicogenic dizziness
  3. VOR with headthrust for labyrinthine concussion
20
Q

What cluster of symptoms does whiplash present with? These are also common findings for concussion.

A 
Headache
Balance problems
Dizziness
Fatigue
>sleep
Numbness and tingling
21
Q

Do people who have had >1 previous concussion recover faster or slower than those experiencing their first?

A

Slower.

22
Q

What concussion symptoms predict a poor outcome?

A

Foggy feeling
Difficulty concentrating
Vomiting
Dizziness

23
Q

What onfield symptom predicts protracted recovery time?

A

Dizziness

24
Q

Does migraine usually occur in central vestibular or peripheral disorders?

A

Central

25
Q

What is the most valuable PT intervention with concussion?

A

Activity modification and patient education.

26
Q

T/F: It is important to begin and progress slowly with concussion management to minimize symptom provocation?

A

True.

27
Q

What exercises would you use in vestibular rehab?

A 
Gaze stability (X1)
Oculomotor (Brock's string)
Sensory integration (manip inputs while changing balance)
28
Q

How is treating concussion different than vestibular hypofunction?

A

Less reps, less often

Training for improved processing, not motor learning

29
Q

As the patient progresses, what movement is important to incorporate?

A

Head movements, especially if they provoked dizziness in the past.

30
Q

When rehabing concussion, the cervical spine is important. Manual therapy, ROM, balance retraining and what other category are important?

A

Cervical proprioception and oculormotor

31
Q

When can exertional training resume?

A

When symptom free at rest.

  • no dizziness
  • no headache
32
Q

When is return to play safe?

A 
Symptom free
-at rest 
-with exertion
No meds
Back to neurocog baseline
33
Q

What is second impact syndrome?

A

Catasprophic cerebral edema after 2nd mild TBI is close succession

  • Coma and severe neuro deficits
  • Age <26
34
Q

How long does chronic traumatic encephalopathy occur after intital injury?

A

years or decades later

-repeated axonal perturbations

Neuroscience IV (7 decks)

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