Concussions Flashcards
Concussion - Definition
Clinical syndrome characterized by an immediate and transient impairment of normal neurological function
Brain injury defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces
Concussion facts
Functional disturbance rather than a structural disturbance
Majority resolve in 7-10 days
Caused by direct or indirect forces - over 100 G-forces in football impacts
Typically rapid onset, but some s/s may take a few hours to develop
Typically s/s do not significantly worsen over time and new ones to do not appear
Clinical neurological signs typically are not present
A concussion will not show on dx imaging
Clinical domains of a concussion
Physical signs
Behavior changes
Cognitive impairment
Sleep disturbance
Physical signs of concussion
Loss of consciousness Loss of balance Vomiting Visual Ha
Behavior changes associated with concussion
Irritability
Aggression
Sadness
Cognitive impairment associated with concussion
Delayed reaction
Lack of concentration
Amnesia
DDX
Concussion
Diffuse axonal injury
Vascular rupture
Fx - laceration of brain
Concussion dx
Dx of exclusion - need to r/o more serious pathology
R/o non-trauma and other trauma related conditions
R/o non-trauma related causes
Stroke Tumor Meningitis Aneurysm Heat stroke DM conditions
R/o other trauma related conditions (direct or indirect)
Cranial fx Intracranial hemorrhaging (increased intracranial pressure) - subdural hematoma - epidural hematoma - intra-cerebral hematoma
Concussion - dx and managment (in a nutshell)
- Primary survey? CABs
- Hx
- Observation
- Palpation?
- Special Testing
- r/o s/s of increased ICP
- symptomatic baseline testing
Concussion - hx
When did injury occur?
MOI
PMH of injury (frequency, duration, etc)
Basic s/s check
Concussion - observation
Behavior
Thought process
Movement quality
Concussion - Palpation
Fx?
Special tests
R/o increased intracranial pressure
Baseline concussion assessment