Concussion-Tran Flashcards

1
Q

What is a concussion?

A

as brain injury and is a complex pathophysiological process affecting the brain, induced by mechanical forces
**can be direct blow to head or hit elsewhere in the body–impulses transferred to the head

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2
Q

T/F There is an increased rate of concussions in high school athletes.

A

True.

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3
Q

What are the risk factors for concussions?

A
hx of prior concussion
female
young
ADD
mood disorders
learning disorders
migraines
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4
Q

What is involved in on-field management of concussions?

A

check ABCs
evaluate for a cervical spine injury or serious brain injury
C-spine injurY: immbolize neck & go to ED
Serious Brain Injury: transfer to ED if see deteriorating mental status or focal neuro exam findings

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5
Q

WHat are the tools used to check for a concussion when a player is sidelined?

A
symptom checklist
balance tests
cognitive evaluation
neuropsychological testing
sometimes imaging
**monitor
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6
Q

T/F It is okay for an athlete to return same day after concussion concern if they do not worsen throughout the day.

A

False. No same day return to play

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7
Q

What are the physical signs & symptoms of concussions?

A
Physical symptoms:
Headache
Nausea
Vomiting
Balance problems
Dizziness
Fatigue
Phonophobia / photophobia
Visual problems
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8
Q

What are the cognitive symptoms of a concussion?

A
Not “feeling right”
Mental fogginess
Difficulty concentrating
Difficulty remembering things
Confusion about recent events
Answering questions slowly
Repeating questions
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9
Q

Any other concussion symptoms?

A
Irritability
Sadness
Nervousness
Emotionality
Drowsiness
Sleeping more or less than usual
Difficulty falling asleep
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10
Q

What is involved in cognitive evaluation?

A

orientation (SAC & Maddocks)
past & immediate memory
learning
conc’n

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11
Q

What is involved in BESS–Balance Error Scoring System?

A

3 stances: narrow double leg, single leg, tandem
2 surfaces: flat firm, medium density foam
20 seconds for each stance w/ hands on hips & eyes closed

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12
Q

What is involved in neuropsychological testing?

A

memory, cognitive speed, reaction time

computerized

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13
Q

T/F No appreciable signs of concussion on CT/MRI

A

True.

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14
Q

When would CT/MRI be warranted?

A

if concerned about intracranial path

bleed, herniation, bony fracture

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15
Q

What is PET/SPECT scan?

A

measures cerebral glucose intake & regional cerebral blood flow
injected radioisotope

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16
Q

What is the treatment for a concussion?

A

relative physical & cognitive rest

17
Q

When can you start treating concussions symptomatically?

A

after 10 hours of injury
acetaminophen-headache **better than NSAIDS
ice massage etc.

18
Q

If headaches linger past 3-4 days…what can be done?

A

consider abortive meds

19
Q

Should meds be given for sleep disturbances & mood disturbances after a concussion?

20
Q

What is the return to play protocol after a concussion?

A

symptom free at rest & exertion before full participation in sports
normal cognitive & balance exam
could take days-months

21
Q

What are the protocols for return to school following a concussion?

A

if you suffer cognitive exertion–longer test times, days off, reduced workload

22
Q

How do you make the diagnosis for chronic traumatic encephalopathy?

A

diagnosis only confirmed after death
proposed effect of sub concussive blows
could have a genetic predisposition for this

23
Q

What is good primary prevention for concussions?

A

enforcement of rules
helmets–limited help
mouth guards-limited help

24
Q

What is good secondary prevention for concussions?

A

good return-to-play management

25
Chronic neurocognitive impairment related to concussion is determined how?
could be present with post-concussion syndrome | demonstrated w/ neuropsychological testing
26
What is chronic traumatic encephalopathy?
neurodegenerative disease--repetitive brain trauma accumulation of tau protein in specific areas of the brain **associated with memory impairment, depression, poor impulse control, cognitive dysfunction
27
WHat is post-concussion syndrome?
most symptoms resolve w/i 7-10 days some last from weeks-years vague symptoms, headache, dizziness, insomnia, cognitive dysfunction, depressed mood, irritability, anxiety, fatigue, noise & light sensitivity
28
What is second impact syndrome?
diffuse cerebral swelling secondary to dysregulation of blood supply to brain increase in intracranial pressure, brain herniation or coma second hit is bad!!!
29
What are 2 potential long-term sequelae from concussions?
chronic traumatic encephalopathy | chronic neurocognitive impairment