Concussions Flashcards
Definition of concussion
Trauma resulting in a change in brain function. Can be direct (a hit) or indirect (MVA)
5 symptoms of concussions
headaches, confusion, loss of consciousness, light + noise sensitivity, nausea, abnormal vision, dizziness
name some delayed signs and symptoms
difficulty sleeping, difficulty concentrating, personality changes, fatigue, depression
Name some facts about etiology
1 million per year 90% go unnoticed or reported
head injuries - recreational athletes (football>hockey>soccer)
Common methods of injury (MOI)
MVA
Sports injuries
getting hit in the head
Coup/contrecoup
1 thing to remember about pathophysiology of concussion
neurometabolic cascade leads to altered homeostasis of the brain
risk factors of concussions
athlete, age, sport, gender, hx of concussions, apoliprotein E4 (genetic risk factor) and post traumatic LOC
Limitations of diagnosis?
Based on accurate reportings from the client/patient
symptom prompting medical attention
nausea
sumptom prompting ER
LOC
Is dx imaging needed
No. it will be negative and is only done to rule out something more serious such as cx # or brain bleeding
t/f pt and at can dx concussions
no, we can give clinical impressions but a dx must come from a physician.
what is dx primarily based on (3)
MOI, accurate reporting of sx, baseline+neuro testing
1 - what are the types of baseline testing
2 - why are they done
1 - King devick + SCAT 5
2 - done to have a baseline of current cognitive functions and baseline of symptoms
what is the better baseline test and why
SCAT 5
looks at many different variables while the king devick only shows one aspect. it takes longer but is more accurate.
what is a limitation of the SCAT 5
difficult to have normative values d/t variances in individuals
What can scores of the SCAt 5 be influenced by
age, gender, previous injuries, adhd, dyslexia etc..
Red flags of concussions
different size pupils
seizures
nausea/vomitting
unusual behaviours
loc
slurred speech
weaknes, numbness and decreased coodination
name 2 ways of testing the following:
vestibular
neurological
balance
1 - nystagmus or pupil dilation
2 - rapid alternating movements or finger to nose
3 - BESS
what does sideline assessment look like
-choose baseline test and perform.
-rule out any red flags
-test ROM + strength or cx spine
-neuro assessment (dematomes, myotomes, reflexes) -> if 2 or more present, could be a red flag
-coordination,
-balance
if there is a concussion but no red flags, educate ++ on protocol
make notes for school/work absences.
Return to learn steps (5)
1 - no activity
2 - daily activities with no symptoms
3 - school activities OUTSIDE of classroom
4 - return to school part time with accomodations
5 - return to school full-time without accommodations
What does rehab in the initial phase
education
active rest, avoiding cognitive stress, no resistance training, wear sunglasses, use earplugs, avoid alcohol
steps to return to play (5)
- minimal/no activity
- light aerobic exercise
- sport specific training
- non contact training drills
- full contact practice
- games
What are things to keep in. mind regarding return to play and return to sport
pt must have no exacerbation of sx for more than 24hrs in order to move onto the next step. if there is an exacerbation of sx, pt must move to previous step until there are no exacerbations
time spent at each step may vary. the majority will recover within 7-10 days
What is PCS
concussion symptoms that last greater than 6 weeks and that plateau in the RTL and RTP protocols
what is SIS
cerebral edema and brain herniation due to concussion (neurometabolic cascade) and the brains inability to regulate intracranial and cerebral perfusion.
what are the longterm effects of concussions
recurring - longer recovery time after each one, increased risk of pcs, increased risk of a next concussion
later on in life - increase risk of MCI, depression and chronic traumatic encephalopathy (CTE)
ways to prevent
mouthguard use, EDCUATION, head and neck strengthening, baseline testing
