Concussion Basics Flashcards

1
Q

What is a concussion?

A

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…”
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2
Q

What does the term ‘concussion’ originate from?

A

It comes from the Latin word ‘concussus,’ meaning ‘to strike together.’

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3
Q

What is mTBI?

A

(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
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4
Q

What is the Glasgow Coma Scale range for a concussion?

A

A score between 13-15.

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5
Q

What are the common causes of concussions?

A
  • falls
  • motor vehicle crashes
  • military combat
  • sports
  • assault
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6
Q

What are the two types of brain acceleration that can cause a concussion?

A

Linear and rotational acceleration.

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7
Q

Which type of brain acceleration plays a more significant role in concussion?

A

Rotational forces.

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8
Q

What forces contribute to brain injury in most head injuries?

A

Both linear and rotational forces.

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9
Q

What is a unique clinical entity related to blast injuries?

A

The explosive shock waves traveling through the brain cause injury.

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10
Q

What is needed for a concussion to occur?

A

Brain acceleration.

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11
Q

What is the neurometabolic cascade in a concussion?

A

A complex sequence of events involving ionic imbalances, energy deficits, and neurochemical release following a head injury.

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12
Q

What happens during the neurometabolic cascade after a concussion?

A

Na+/Ca+ influx, K+ efflux, and the release of glutamate.

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13
Q

What leads to the metabolic energy crisis in a concussed brain?

A

The increased energy demand for ATP to restore ionic balance, coupled with impaired ATP production.

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14
Q

What is the impact of decreased cerebral blood flow after a concussion?

A

It exacerbates the brain’s energy deficit, leading to prolonged symptoms.

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15
Q

Why is extreme fatigue common after a concussion?

A

The brain has an energy mismatch due to the high energy demand and low supply, causing fatigue.

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16
Q

Why is concussion diagnosis challenging?

A

Concussion occurs at the cellular level, making it difficult to detect with standard imaging like CT or MRI.

17
Q

What are the acute physical signs of a concussion?

A

Headache, dizziness, nausea, balance problems, and visual disturbances.

18
Q

What are the cognitive symptoms of a concussion?

A

Difficulty concentrating, memory problems, confusion, and feeling foggy.

19
Q

What are the behavioral changes observed in a concussion?

A

Mood changes, irritability, anxiety, and nervousness.

20
Q

.

A

.

21
Q

What is the recommended acute management for the first 24-48 hours after a concussion?

A

Relative rest with limited physical and cognitive activity, and reduced screen time.

22
Q

When should a gradual return to physical activity begin after a concussion?

A

After the first 24-48 hours, starting with light aerobic exercises.

23
Q

What is the Return to Learn (RTL) strategy?

A

A stepwise approach to gradually reintroduce cognitive activities and school attendance post-concussion.

24
Q

What are the risk factors for prolonged recovery from a concussion?

A

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.

25
Q

What might contribute to persistent post-concussive symptoms?

A

Pre-existing conditions like mental health issues, visual problems, and chronic pain.

26
Q

What is CTE and how is it diagnosed?

A

Chronic Traumatic Encephalopathy, diagnosed post-mortem by examining brain tissue.

27
Q

What are potential long-term effects of repeated concussions?

A

Increased risk of neurodegenerative conditions like CTE and Traumatic Encephalopathy Syndrome (TES).