Head and Neuro

Question 1

sport related concussion
1. overview
2. signs and symptoms onset
3. clinical presentation
4. SCAT6

Answer 1

1. lowest severity of traumatic brain inj
2. range of signs and symptoms may present immediately or evolve over minutes, hours, or days; usually resolve within days but may be prolonged, may not involve loss of consciousness
3. physical, mental, and emotional symptoms, cognitive deficits like difficulty orientation self, memory or concentration issues, motor deficits with coordination and balance (can’t control body like normal)
4. diagnostic tool with rating 0-6 with symptoms of concussion

Question 2

structure of brain
1. brain overview
2. matter of the brain

Answer 2

1. brain is tethered to sp cd with texture like almost ripe avocado, sits in CSF, has high water content thus can’t compress well since water tension inside resists
2. white matter (axon) inside with gray matter (cell body) outside, different layers react differently to ext forces, cell bodies pull away from axons

Question 3

biomechanics of concussion

Answer 3

1. moving object hits head
2. head hits stationary object
3. head acceleration-deceleration without direct head contact from whiplash of trunk
4. in all cases mech E transferred to brain with angular acceleration of brain around axis of rotation in the cervical spine

Question 4

pathophysiology of concussion
1. mechnoporation
2. physiological recovery
3. HR variabilty

Answer 4

1. separation of the layers of the brain stretches the axons generating mechanical distension of the ion channels (mechanoporation) for influx of Na+ and Ca2+ and outflux of K+ causes disruption in ion balance, acute release of glutamate results in mass depolarization; to return to homeostasis Na+/K+ pumps require lots of ATP to restore homeostasis but due to influx of Ca2+, mitochondrial function of oxidative processes disputed and can’t use glycolytic processes due to acute decrease in cerebral blood flow and decrease in blood glucose, therefore can’t regulate ion concentration
2. often takes longer than symptom recovery
3. measured as RR interval, decrease variability after concussion, change in HRV reflect greater SNA after concussion, imbalance between SNA and PNA cause inability to sleep since body can’t relax

Question 5

emergency concussion situations

Answer 5

1. skull fractures, usually caused by small fast object since high focused E
2. intracranial hematoma increases intracranial pressure and put pressure on brain can force fluid to leak and bruises to form
3. other symptoms of emergency are severe and worsening headache, vomiting, and impaired pupil response