Lecture 4 - Concussion Management Flashcards
what is a concussion
a brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces
how many concussions happen per year in USA and by which sports
1.6-3.8 million concussions per year in USA
- rugby, football, hockey, basketball and soccer are the sports with the highest incidence
concussion recovery rates
- 80-90% recover in 7-10 days
- 10-15% of concussions have persistent symptoms (greater than 10 days)
high certainty risk factors of a concussions
- history of prior concussion
- match play vs practice play
how are concussions diagnosed
the suspected dignosis of concussion can include one or more of the following clnical domains
1. symptoms
2. physical signs
3. behavioural changes
4. cognitive impairment
5. sleep disturbance
how are concussions assessed
on field Ax
- scat5
clinical ax
- VOMS
- neuropsychological test
- reaction time
- balance assessment
components of the SCAT5
Maddocks score
- attention and memory
Sideline Ax of concussion (SAC)
- cognition
Balance error scoring system (BESS)
- postural control
VOMS
Vestibular ocuar motor screen
- Patients verbally rate cahnges in headache, dizziness, nausea and fogginess with their immeiate preassessment state on a sclae of 0 to 10 after each VOMS assessment to determine if each assessment provoked symptoms. (stick and move it around)
Zurich consensus statement
The cornerstone of concussion management is physical and cognitive rest until the acute symptoms resolve and then a graded program of exertion prior to medical clearance and RTP
- see slides for stages of rehab/RTP
adult vs child concussions
concussed high school athletes take twice as long to recover than college and professional athletes, and preadolescent children may take even longer
- focus on return to school before return to sport
