Concussions Flashcards
1
Q
Concussion: Glasgow score
A
- GCS score of 13-15
2
Q
Concussion Def
A
- Mild traumatic brain injury (TBI)
- May or may not include LOC (sports mostly lack LOC)**
- Symptoms
- rapid onset of brief impairment (neurological fxn)
- resolves spontaneously
- Normal brain structure
- Vacant stare
- Delayed/slurred speech
- Disorientation
- Memory deficits
- Elderly = Falls**
- Young = Crashes**
- Contact sports
- high school higher rates than college
- Soldiers
- explosions, shrapnel, bullet wounds, etc
- Risk Factors
- <5 yo
- >60 yo
- Secondary Injury
- Wallerian degeneration
- release of acetylcholine, glutamate, aspartate (excitatory neurotransmitters)
- free radicals
- Axonal Rupture
- shear and tensile forces
3
Q
Cerebral Edema
A
- Overfills cranial vault
- Flattening of gyri
- Narrowing of sulci
- Compression of ventricular cavities
- Herniation
4
Q
Hallmark of concussions**
A
- Confusion
- Amnesia
5
Q
Standardized Assessment of Concussion (SAC)
A
- Used for athletes
6
Q
How long after a concussion should you monitor? What should you do during?
A
- At least 24 hours
- Bc of intracranial complication risk
- Should awake from sleep every 2 hours**
- No physical or mental strain for 24 hours
7
Q
When should you hospitalize pts?
A
- Glasgow score of <15
- Abn CT
- bleeding
- cerebral edema
- Seizures
8
Q
When should caregiver seek immediate medical help?
A
- Not able to awaken pt
- severe/worsening headaches
- Restlessness/unsteady/seizures
- Vision difficulties
- Vomit, Fever, Stiff neck
- Incontinence
- Weakness/numbness
9
Q
Second Impact Syndrome
A
- Diffuse cerebral swelling, rare but fatal
- disordered cerebral autoregulation
- cerebrovascular congestion
- malignant cerebral edema
- inc. ICP
- After a 2nd concussion, while pt still symptomatic from earlier concussion
- BOXERS**
10
Q
Postconcussion Syndrome
A
- Head and neck structure trauma
- Symptoms
- HA
- Dizzy
- Neuropsychiatric sx
- Cog impairment
- Develop first days after TBI
- Resolves w/in weeks to months
- RISK for developing ALS and Parkinson
11
Q
Motor Neuron Disease
A
- Chronic traumatic encephalopathy
- (confirmed pathologically)
- Risk Factor
- Football
- Soccer
12
Q
Post-Traumatic Headaches
A
- w/in 7 days after TBI
- Can be latent up to 3 months
- May be indistinguishable from nontraumatic migraines or tension HA
13
Q
Cranial Nerve Injuries
A
- Can cause:
- anosmia/hyponosmia
- diplopia
- facial pain
- occipital neuralgia
14
Q
Cumulative Neuropsychological Impairement
A
- A type of concussion sequelae
- Manifestations
- behavior/personality changes
- depression
- suicide
- parkinsonism
- speech/gait abnormalities
15
Q
Post-Traumatic Epilepsy
A
- TBI pt are 2x at risk of epilepsy w/in next 5 years
- Seizures w/in 1st week isn’t epilepsy (acute symptomatic events)
- Do not tx prophylactically w/ anti-convulsants
- they don’t work to prevent seizures after TBI
