SRI Concussion

Question 1

what is the consensus definition of SRI Concussion

Answer 1

a traumatic brain injury caused by
a direct blow to the head, neck or body resulting in an impulsive force being transmitted to the brain that occurs in sports
and exercise-related activities.

Question 2

what is the brief pathophysiology of an SRI concussion

Answer 2

trauma to the brain as a result of an exercise-relate activities, initiates a neurotransmitter
and metabolic cascade, with possible axonal injury, blood flow
change and inflammation affecting the brain

Question 3

how can imaging be used to detect an SRI concussion

Answer 3

not seen with standard neuroimaging CT or MRI,
can be seen in functional, blood flow or metabolic imaging studies

Question 4

describe the prevention strategy for SRI concussion

Answer 4

minimise burden of injury
risk of recurrent injury and potential for persisting symptoms

Question 5

how is sport related concussion assessed

Answer 5

SCAT 6
mBESS

Question 6

How is SCAT 6 conducted

Answer 6

1. Athlete background - hospitalised head injury, dx migraine, dyslexia, learning disability, dx ADHD, dx depression, anxiety
2. symptom evaluation - confusion, drowsiness, blurred vision, balance issues, nausea/vomiting
3. Cognitive Screening - orientation(month/date/day/year/time), immediate memory,concentration(list digits backwards)
4. Co-ordination and Balance - modified Balance Error Scoring System - double leg stance, tandem stance, SLS, timed tandem gait
5. Delayed Recall -
6. Decision

Question 7

long term effects of concussion

Answer 7

chronic trauma encephalopathy and TES
Dementia/Alzheimers
Cervical spine injury
cervical spine injury
second impact syndrome

Question 8

describe the initial clinical assessment of a patient suffering from SRC

Answer 8

First Aid (assume CxSp injury if unconscious)
SCAT 6 (Child SCAT for </= 12)
Rapid Sideline Assessment up to 72hrs post concussion
Symptom evaluation, Cognitive Assessment & Coordination + balance
Includes mBESS
Timed tandem gait & optional dual task gait new 2023
Cervical spine assessment
Oculomotor and vestibular function new 2023

Question 9

What is the general management plan for SRC

Answer 9

NO return to play within first day of concussion
physical and cognitive relative rest - light aerobic exercise
expert medical review if symptoms persist after 10/7
Cervicovestibuar rehabilitation is indicated for athletes with neck pain, headaches, dizziness and/or balance problems

Question 10

describe the - return to learn management strategy for SRC

Answer 10

Gradual return to full time school
1. daily activities that only involve moderate exacerbation start 1-15mins and progress. minimal screen time
2. school activities - cognitive activities and reading outside of school
3. partial return to school - light school work
4. full return to school - gradually progress school time until can return to school normally with minimal symptoms

Question 11

describe SRC return to sport management strategy

Answer 11

1. symptom limited activity - engage in activities that do not exacerbate symptoms
2. aerobic exercise start 55%maxHR progress to 70%maxHR using stationary cycling or walking should provoke at most mild
3. individual sport specific exercise/training
4. non-contact high intensity more challenging drills
5. full contact practice - normal training
6. return to sport