Head injuries

Question 1

concussion

Answer 1

mild form of TBI

- might or might not involve LOC

Question 2

how does one get a concussion?

Answer 2

direct contact and/or acceleration/deceleration forces

- a direct blow to the head doesnt have to occur

Question 3

MOA of a concussion

Answer 3

injury causes stretching of axons leading to a metabolic cascade

Question 4

whiplash injury

Answer 4

injury of inertia
coup: bone hits the frontal region of brain

contrecoup: bone hits the occipital region of the brain

Question 5

dashboard injury

Answer 5

injury of momentum

coup: frontal region of brain hits the skull
contrecoup: occipital region of brain hits the skull

Question 6

epidemiology of TBI

Answer 6

MVA (45%)
falls
occupational
recreational
assults

Question 7

who has a higher risk of having a TBI

Answer 7

women in everysport

Question 8

GCS low/high

Answer 8

high- 15

low- 3

Question 9

components of the GCS

Answer 9

eye opening
best verbal response
best motor response

Question 10

hallmarks of concussin

Answer 10

confusion and amnesia

- usually can recall what happened before and after event

Question 11

early signs of concussion

Answer 11

confusion 
amnesia
HA
N/V
vacant stare
lack of coordination 
etc

Question 12

late findings

Answer 12

• emotional reactions out of proportion to circumstances

- cog, sleep, mood disturbances

Question 13

grade 1

Answer 13

transient confusion
NO LOC
symptoms resolve within 15 min

Question 14

grade 2

Answer 14

transient confusion
NO LOC
persist longer than 15 min

Question 15

grade 3

Answer 15

any LOC

Question 16

acute evaluation

Answer 16

neuro assessment and mental status testing

Question 17

when to obtain imaging for TBI

Answer 17

LOC for longer than 1 minute
persistant mental status alterations
abnormal neuro exams

Question 18

red flags

Answer 18

• focal deficits
• seizure
• bleeding diathesis
• anticoag use
• worsening symptoms
• LOC
• skull fracture
• GCS <15 2 hours after injury

Question 19

observation at home

Answer 19

close obs for 24 hours every 2 hours

Question 20

RTP stage 1

Answer 20

no activity- complete rest

Question 21

RTP stage 2

Answer 21

light aerobic excercise

Question 22

RTP stage 3

Answer 22

sport-specific excercise

Question 23

RTP stage 4

Answer 23

non-contact training drills

Question 24

RTP stage 5

Answer 24

full contact practice

Question 25

RTP stage 6

Answer 25

complete activity in games

Question 26

return to school

Answer 26

once student is able to tolerate symptoms while doing cog activities for 30-45 min

adjustments foe 3 weeks

Question 27

when would a student need accomidations

Answer 27

symptoms last beyond 3 weeks- 504 plan

academic mod- IEP

Question 28

post-concussion syndrome

Answer 28

3 or more symptoms for more than 1 month

depression (common late symptom)

headaches

epilepsy

vertigo

Question 29

second impact syndrome

Answer 29

patients with hx of concussions are at risk of developing chronic traumatic encephalopathy

Question 30

what doesn’t prevent TBI

Answer 30

helmets
mouth guards
external helmet cushions

Question 31

what helps prevent TBI

Answer 31

team regulations against rough play

education and early diagnosis