Concussion-Tran Flashcards
What is a concussion?
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
T/F There is an increased rate of concussions in high school athletes.
True.
What are the risk factors for concussions?
hx of prior concussion female young ADD mood disorders learning disorders migraines
What is involved in on-field management of concussions?
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
WHat are the tools used to check for a concussion when a player is sidelined?
symptom checklist balance tests cognitive evaluation neuropsychological testing sometimes imaging **monitor
T/F It is okay for an athlete to return same day after concussion concern if they do not worsen throughout the day.
False. No same day return to play
What are the physical signs & symptoms of concussions?
Physical symptoms: Headache Nausea Vomiting Balance problems Dizziness Fatigue Phonophobia / photophobia Visual problems
What are the cognitive symptoms of a concussion?
Not “feeling right” Mental fogginess Difficulty concentrating Difficulty remembering things Confusion about recent events Answering questions slowly Repeating questions
Any other concussion symptoms?
Irritability Sadness Nervousness Emotionality Drowsiness Sleeping more or less than usual Difficulty falling asleep
What is involved in cognitive evaluation?
orientation (SAC & Maddocks)
past & immediate memory
learning
conc’n
What is involved in BESS–Balance Error Scoring System?
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
What is involved in neuropsychological testing?
memory, cognitive speed, reaction time
computerized
T/F No appreciable signs of concussion on CT/MRI
True.
When would CT/MRI be warranted?
if concerned about intracranial path
bleed, herniation, bony fracture
What is PET/SPECT scan?
measures cerebral glucose intake & regional cerebral blood flow
injected radioisotope
What is the treatment for a concussion?
relative physical & cognitive rest
When can you start treating concussions symptomatically?
after 10 hours of injury
acetaminophen-headache **better than NSAIDS
ice massage etc.
If headaches linger past 3-4 days…what can be done?
consider abortive meds
Should meds be given for sleep disturbances & mood disturbances after a concussion?
nope
What is the return to play protocol after a concussion?
symptom free at rest & exertion before full participation in sports
normal cognitive & balance exam
could take days-months
What are the protocols for return to school following a concussion?
if you suffer cognitive exertion–longer test times, days off, reduced workload
How do you make the diagnosis for chronic traumatic encephalopathy?
diagnosis only confirmed after death
proposed effect of sub concussive blows
could have a genetic predisposition for this
What is good primary prevention for concussions?
enforcement of rules
helmets–limited help
mouth guards-limited help
What is good secondary prevention for concussions?
good return-to-play management
Chronic neurocognitive impairment related to concussion is determined how?
could be present with post-concussion syndrome
demonstrated w/ neuropsychological testing
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
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
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!!!
What are 2 potential long-term sequelae from concussions?
chronic traumatic encephalopathy
chronic neurocognitive impairment
