mTBI + concussion

Question 1

what results from head trauma

Answer 1

axonal sheering forces that tear neurons apart

Question 2

what is the coup vs contre coup

Answer 2

coup = injury that occurs under the site of initial impact with the skull
contre coup = contusion resulting from the brain contacting the skull on the side opposite from the initial impact

Question 3

what is diffuse axonal injury (DAI)

Answer 3

tearing the cell membrane will result in ionic imbalances that alter electrical signalling in nerve cells
- all thresholds change
- effects functioning of axons and LTP (weakens connections if they’re firing properly)

Question 4

what is the difference in healing between grey and white matter

Answer 4

grey = won’t heal itself
white = has the potential to heal

Question 5

when will hyperintense (white) regions show in brain imaging

Answer 5

if damage if severe enough
- most “subconcussive” impacts won’t show any clear hyperintense regions however DAI is still occuring at the microscopic level

Question 6

what is a hematoma

Answer 6

pooling of blood between the brain and protective tissues or between the tissues and skull
(can be fatal)

Question 7

what is a subdural hematoma

Answer 7

outside brain - between dura mater adn skull
- can drill into brain and decompress

Question 8

what is a intracerebral hematoma

Answer 8

inside brain
- harder to decompress and more severe

Question 9

what causes chronic traumatic encephalopathy (CTE)

Answer 9

chronic exposure to head trauma
- progressive neurological disorder

Question 10

how does CTE show up in autopsies

Answer 10

dark staining on brain
- buildup of tao protein (comes from damaged cells)
- can’t fire properly and reduces communication

Question 11

what are the symptoms of CTE

Answer 11

changes in personality (impulse and aggression)
reduction in memory and other cognitive functions
can’t regulate emotions well so they often reach for drugs, alcohol, gambling, etc

Question 12

what are 4 clinical tools for assessing concussion

Answer 12

glascow coma scale (GCS)
sport concussion assessment tool 5 (SCAT-5)
head check health
protxx

Question 13

what is GCS

Answer 13

used in clinic to rate symptoms of concussion
involves having the patient open their eyes, answer questions, and make involuntary mvmts

Question 14

what is the SCAT-5

Answer 14

most widely used scale for rating symptoms of concussion
provide a rating score for various symptoms

Question 15

what is head check health

Answer 15

app based tool
used by pro and amateur sports leagues to track concussion testing and monitor compliance with RTS protocols

Question 16

what is protxx

Answer 16

company that makes a wearable accelerometer that measures balance performance
app based test is able to detect balance impairments associated with concussion

Question 17

what type of head trauma causes the highest rotational accelerations

Answer 17

getting punched - also torsion applied to the brainstem
(football = higher linear translations)

Question 18

what damage causes the symptoms of concussions we see

Answer 18

damage to the brainstem or vestibular system

Question 19

what is the difference of VSR responses in fighters

Answer 19

career fighters have a lower and later VSR response correlated with the number of repetitive head impacts
(fighters show advanced aging of vestibular system)

Question 20

what is the difference in VSR amplitude pre sparring, immediately post, and 24 hours post

Answer 20

pre sparring and 24 hours post are quite similar
immediately post = smaller amplitude (acute drop)