Concussion - Kesserwani

Question 1

What is the most common presenting symptom of a concussion?

Answer 1

Headache is the #1. Difficulty concentrating, fatigue, drowsiness, and dizziness are also common.

Question 2

What imaging changes are common after concussion?

Answer 2

Usually there are no visible changes after concussion

Question 3

Is LOC necessary in concussion?

Answer 3

LOC is not necessary for concussion - only 10% of concussions are associated w/ LOC

Question 4

What is the anatomical pathology of the greater occipital nerve coming from C2 in occipital headaches after concussion?

Answer 4

The trigeminal nucleus caudalis is continuous with the dorsal horn of C2-C4 in the spinal cord and can result in greater occipital nerve headaches.

Question 5

What are the risk factors linked to chronic neurobehavioral impairment in professional athletes?

Answer 5

• Prior concussion
• Longer exposure to the sport
• Having the ApoE4 gene

Question 6

Chronic traumatic encephalopathy (characterized by headache, concentration problems, depression, memory loss, or even motor disorders and lobar degeneration) due to repeated mild traumatic injuries to the brain can result in what neurodegenerative histologic appearance?

Answer 6

Taupathy - tau protein accumulation (hyperphosphorylated microtubulin associated proteins)

Question 7

Within the first 72 hours of concussion, the metabolic crisis occurs due to lack of what to the tissues?

Answer 7

Blood flow - does not meet energy demand of tissues

Question 8

Within the first 72 hours of concussion, the metabolic crisis occurs resulting in what ion flux?

Answer 8

Potassium efflux

Question 9

Within the first 72 hours of concussion, the increased demand for ATP results in what metabolic change and accumulation of what substance?

Answer 9

Poor blood flow results in cells moving toward glycolysis and lactate accumulates

Question 10

Rotational forces during injury are transmitted to what structure in the brain?

Answer 10

Brain stem - dizziness, balance issues

Question 11

During a front to back coup-contracoup injury pattern, what areas of the brain are damaged and what symptoms present?

Answer 11

Occipital lobe - visual problems
Temporal lobe hit middle cranial fossa - memory
Frontal lobe - smelling problems, cognitive dysfxn