Concussion

Question 1

Coup is where ? Contre?

Answer 1

At site of impact

Oppo side

Question 2

After conussion what can you seE?

Answer 2

Axonal damage
Increase in glucose and decrease after (neurometabolic)
Decrease CBF

Question 3

Tools for Concussion?

Answer 3

Neuropsych test
ImPACT
Cogsport

Sideline: SCAT5/child/SAC

Balance: SWAY/BESS/BIODEX/King-Devick

Question 4

Imaging used in Concussion/

Answer 4

Moving away from CT, using MRI.
White matter integrity via DTI
Functional MRI

Question 5

What are some long term problems of concussion?

Answer 5

Post-concussion syndrome (persistent 3 symptoms within month)

Difference with concussion is that its separate Dx

Question 6

What are types of post-concussion disorders?

Answer 6

Physiologic: impaired cerebral metabolism
Vestibulo-ocular
Cervicogenic: dysfx of cervicospinal system

Symptoms can overlap with other psychological symptoms

Question 7

Physiological PCD notes?

Answer 7

From altered cell Fx and CBF
Elevated Resting HR, symptoms get worse with exercise***
Managed with Rest and accomodation

Question 8

Vestibuloocular PCD

Answer 8

More so vestibular symptoms( impaired balance VOR, accades, convergence

Rarely show symptoms during exercise program..

Tx with vision and balance shit

Question 9

Cervicogenic PCD

Answer 9

More so Dysfx of X spine/headache in back of head, ROM,stiff

Theres dec lordosis/muscle tender/impaired head position sense.

Tx with Cspine therapy. Good things MSPT aint teach me shit.

Question 10

Chronic Traumatic Encephalopathy

Answer 10

Associated with repetive brain trauma (even at low threshold)

Mood/behavior/cog symptoms
Impulsive/depressed/rage/memory loss

Question 11

CTE is characterized by

Answer 11

Neurofibrillary tangles (usually frontal so u see mood issues)
Amyloid plaque is alzheimers so CTE doesnt really have that.

Decrease brain weight/larger ventricles/thin corpus callosum/cyst in septum pellucidum

Question 12

Gross Changes for CTE?

Answer 12

Decrease brain weight/
larger ventricles/
thin corpus callosum/
cyst in septum pellucidum

Question 13

Types of active Rehab?

Answer 13

Education that it will get better (psychoeducation)
Cog/neurocog : like King Davick
PT: Cspine/ motor retraining
Vestib retraining
Ocular retraining
Aerobic Exercise

Question 14

Return to learn

Stages

Answer 14

1: activites at home
2: school activities*
3: School part time
4: School full time.

Question 15

Return to Play:

Answer 15

1: symptom limited activity
2: light aerobic
3: Sport-specific exerise
4: Noncontact drills
5: Full contact drills
6: return to sport