Concussion

Question 1

what is a concussion?

Answer 1

ACCELERATION-DECELERATION MOVEMENT OF HEAD ESPECIALLY WITH ANGULAR-ROTATORY COMPONENT SHEARING OF AXONS & LOC LOC

Question 2

What is a diffuse axonal injury?

Answer 2

TRAUMATIC COMA > 6 HOURS-24 hours SMALL LESIONS IN WHITE MATTER TRACTS PRESUMED WIDESPEAD SHEARING INJURY COMA OF 6-24 HOURS IS MILD DAI

Question 3

What is brainstem & hypothalamic injury present?

Answer 3

AUTONOMIC DYSFUNCTION—TACHY OR BRADYCARDIA, HBP, HYPERHIDROSIS, FEVER, POIKILOTHERMIA—COMMON IN ACUTE, SEVERE DIFFUSE AXONAL INJURY PROLONGED LOC FROM DAI—LESIONS OF MIDBRAIN, TEGMENTUM, RAS,

Question 4

What is a Contusion?

Answer 4

FOCAL PARENCHYMAL HEMORRAHGES FROM INNER SURFACE OF SKULL INFERIOR FRONTAL AND TEMPORAL LOBES COUP / CONTRECOUP- blow and opposite blow (traveling of brain to opposite side)

Question 5

What is found on the brain in a contusion?

Answer 5

JAUNE PLAQUES”- yellow plaques (staining of the brain surface yellow)

Question 6

What is subdural hematoma?

Answer 6

COLLECTION OF BLOOD BETWEEN DURAL AND ARACHNOID MEMBRANES VENOUS DAMAGE ON BRAIN SURFACE OR DURAL SINUSES FROM BRAIN MOVEMENT- low pressure

Question 7

Who is susceptable in subdural hematoma?

Answer 7

ELDERLY OR ALCOHOLIC PTS ARE SUSCEPTABLE

Question 8

What is acute Subdural hematoma? What is chronic subdural hematoma?

Answer 8

acute-within72 hours chronic 21 days

Question 9

How do you treat a chronic subdural hematoma?

Answer 9

TRAUMA MAY BE TRIVIAL R/O COAGULOPATHIES INCLUDING ANTICOAGULANT MEDICATIONS ENCAPSULATION—MAY ENLARGE MAY PRESENT WITH DEMENTIA CT HYPO OR ISODENSE CRESCENT

Question 10

What is a epidural hematoma?

Answer 10

—TEAR IN WALL OF MENINGEAL ARTERY

—15% MAY BE A DURAL SINUS

—75% WITH SKULL FRACTURE

—MORE IN YOUNG AS DURA ADHERES TO SKULL MORE AS WE AGE

—LUCID INTERVAL

—DETERIORATION CAN BE RAPID

—

Question 11

What is post concussion syndrome?

Answer 11

—40% OF HEAD INJURIES COMPLAIN OF :

—Headache tinnitus restlessness

—Dizziness irritability

—Fatigue inability to concentrate

—Insomnia or hypersomnia

—Blurred vision

—Anxiety / depression

Question 12

How long does symptoms with post concussion syndrome last?

Answer 12

—Sx may persist for weeks to years

—Pts. May not have lost consciousness

—Normal neuro exam and imaging

—Correlation with severity is poor

—Sx may often seem psychogenic

—Psych & social factors increase chance and prolong sx

Question 13

What are signs and symptoms of a concussion according to the AAN?

Answer 13

1) HA and sensitivity to light and sound
2) changes to reaction time, balance, and coordination
3) changes in memory, judgment, speech, and sleep
4) LOC or a blackout

Question 14

Who takes longer to recover from concussions?

Answer 14

High school students

manage more comservatively

Question 15

Who i sthe greatest risk for concussion?

Answer 15

—Greatest in football, rugby, then hockey and soccer

—For young women and girls—soccer and basketball