Concussion Basics Flashcards
What is a concussion?
A mild traumatic brain injury (mTBI) caused by biomechanical forces that impair physiological brain function.
Consensus Statement Definition of Concussion:
- “Sport related concussion is a traumatic brain injury caused by a direct blow to the head, neck or body resulting in an impulsive force being transmitted to the brain…”
What does the term ‘concussion’ originate from?
It comes from the Latin word ‘concussus,’ meaning ‘to strike together.’
What is mTBI?
(a) Mild Traumatic Brain Injury, often used interchangeably with concussion.
(b) Sport-Related Concussion (SRC)
- A type of concussion related to sports activities.
- 4-6 x more likely to sustain another concussion
What is the Glasgow Coma Scale range for a concussion?
A score between 13-15.
What are the common causes of concussions?
- falls
- motor vehicle crashes
- military combat
- sports
- assault
What are the two types of brain acceleration that can cause a concussion?
Linear and rotational acceleration.
Which type of brain acceleration plays a more significant role in concussion?
Rotational forces.
What forces contribute to brain injury in most head injuries?
Both linear and rotational forces.
What is a unique clinical entity related to blast injuries?
The explosive shock waves traveling through the brain cause injury.
What is needed for a concussion to occur?
Brain acceleration.
What is the neurometabolic cascade in a concussion?
A complex sequence of events involving ionic imbalances, energy deficits, and neurochemical release following a head injury.
What happens during the neurometabolic cascade after a concussion?
Na+/Ca+ influx, K+ efflux, and the release of glutamate.
What leads to the metabolic energy crisis in a concussed brain?
The increased energy demand for ATP to restore ionic balance, coupled with impaired ATP production.
What is the impact of decreased cerebral blood flow after a concussion?
It exacerbates the brain’s energy deficit, leading to prolonged symptoms.
Why is extreme fatigue common after a concussion?
The brain has an energy mismatch due to the high energy demand and low supply, causing fatigue.
Why is concussion diagnosis challenging?
Concussion occurs at the cellular level, making it difficult to detect with standard imaging like CT or MRI.
What are the acute physical signs of a concussion?
Headache, dizziness, nausea, balance problems, and visual disturbances.
What are the cognitive symptoms of a concussion?
Difficulty concentrating, memory problems, confusion, and feeling foggy.
What are the behavioral changes observed in a concussion?
Mood changes, irritability, anxiety, and nervousness.
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What is the recommended acute management for the first 24-48 hours after a concussion?
Relative rest with limited physical and cognitive activity, and reduced screen time.
When should a gradual return to physical activity begin after a concussion?
After the first 24-48 hours, starting with light aerobic exercises.
What is the Return to Learn (RTL) strategy?
A stepwise approach to gradually reintroduce cognitive activities and school attendance post-concussion.
What are the risk factors for prolonged recovery from a concussion?
History of migraines, multiple concussions, being female, and severe initial symptoms.
Strongest predictor of slower recovery = The severity and number of symptoms in the first few days after the injury.
What might contribute to persistent post-concussive symptoms?
Pre-existing conditions like mental health issues, visual problems, and chronic pain.
What is CTE and how is it diagnosed?
Chronic Traumatic Encephalopathy, diagnosed post-mortem by examining brain tissue.
What are potential long-term effects of repeated concussions?
Increased risk of neurodegenerative conditions like CTE and Traumatic Encephalopathy Syndrome (TES).
