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Block 7 Week 5 > Tran: Concussion > Flashcards

Tran: Concussion Flashcards

1
Q

What are some of the risk factors for concussions?

A
  1. history of prior concussion
  2. females more likely to get a concussion in the same sport as males
  3. certain sports and positions
  4. younger athletes more prone to longer recovery periods and more severe injuries
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2
Q

Initially, when a player in downed and you suspect a concussion, what should you do?

A

check airway, breathing, circulation
evaluate for c-spine injury - if you think they’ve injured their spine, immobilize their neck and transfer to ER
evaluate for brain injury - if you think they’ve seriously damaged their brain, ER immediately

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3
Q

List four tools that can be used to evaluate an athlete on the sideline if a concussion is expected

A 
physical exam
symptoms testing/checklist
balance tests
cognitive test
also, neuropsychological test
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4
Q

When is imaging for concussions warranted?

A

usually not indicated - only used in those in whom pathology is suspected, like bleeds, herniation, bone fracture, etc

**signs of concussion are not visible via imaging

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5
Q

Symptoms of a concussion?

A 
headache
nausea
vomiting
dizziness
balance probs
fatigue
visual problems
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6
Q

Check out this list of symptoms:

Not “feeling right”
Mental fogginess
Difficulty concentrating
Difficulty remembering things
Confusion about recent events
Answering questions slowly
Repeating questions
Irritability
Sadness
Nervousness
Emotionality
Drowsiness
Sleeping more or less than usual
Difficulty falling asleep
A

Cool

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7
Q

What are the four things you evaluate for when you have a concussion patient?

A

orientation
past and immediate memory
learning
concentration

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8
Q

What are some tests used in the Standardized assessment of concussion?

A

read numbers backwards
word recall (memory)
orientation to person/place/time

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9
Q

What do you do to test for balance?

A

have the patient perform 3 stances: narrow stance, single leg stance, tandem stance (one foot in front of the other) - hold each stance for 20 seconds

**deduct pts for opening eyes, lifting hands off hips, stumbling/falling, being out of position for >5sec

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10
Q

Objective measurement of occult cognitive impairment

Evaluates several domains of cognition, focusing on memory, cognitive speed, and reaction time

A

neuropsychological testing

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11
Q

Neuropsychological testing:

T/F: Should be used in isolation to diagnose concussions

T/F: Able to detect postconcussive cognitive deficits

T/F: Usually compared to baseline done ideally prior to having concussions

T/F: Can be interpreted by anyone

A

False - use as a comprehensive concussion management strategy

True

True

False - should be interpreted by trained professional familiar with the neuropsychological testing and with its limitations

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12
Q

measures cerebral glucose intake and regional cerebral blood flow; not standard of care

A

PET/SPECT scan

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13
Q

How to treat a concussion?

A

engage in physical/cognitive rest

avoid physical/cognitive activities that increase symptoms

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14
Q

In the acute phase of a concussion, like 0-10 hrs after the injury, don’t give (blank)

A

mental status altering meds

**after this time period, you can treat the symptoms

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15
Q

T/F: There is sound evidence that certain medications can treat the acute symptoms of concussion.

A

False; just, no

**can use acetaminophen for headache, but don’t use NSAIDs in case of a bleed!

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16
Q

Are medications indicated for sleep disturbances or mood disturbances post-concussion?

A

While sleep disturbances are common, no role for sleep-promoting medications or stimulants in acute treatment of concussion
Mood disturbances also common as well, but again, medications not indicated in acute setting

17
Q

When can a player return to the field after a concussion?

A

when the athlete is symptom free at rest and exertion
normal cognitive and balance exams

**may take days to months before final clearance

**ease the player back into physical exertion - no activity, light exercise, football specific exercise, drills, routine training, OK

18
Q

T/F: Although there are currently no guidelines in regards to when an athlete can return to school after a concussion, they may be offered longer tests times, days off, or reduced workload.

A

True

19
Q

If returning to play too soon, decreased reaction time may lead to prolongation or increased risk of recurrence for concussion. What is this referred to as?

A

second impact syndrome

20
Q

T/F: There is a direct positive correlation between the severity of concussion and the likelihood to develop postconcussion symptoms like headache, dizziness, insomnia, etc.

A

False - no correlation

21
Q

T/F: Concussion symptoms usually resolve in a week, but may last weeks to years.

A

True

22
Q

Treatment of postconcussion syndrome is (blank)

A

time

23
Q

Diffuse cerebral swelling thought to be secondary to dysregulation of blood supply to brain, leading to increase in intracranial pressure, brain herniation, and possibly coma/death

A

second impact syndrome

24
Q

Long term sequelae that MAY occur postconcussion

A

chronic traumatic encephalopathy

chronic neurocognitive impairment

25
Q

Defined as neurodegenerative disease associated with repetitive brain trauma and characterized pathologically by accumulation of tau protein in specific areas of the brain
Associated with memory impairment, depression, poor impulse control, cognitive dysfunction

A

chronic traumatic encephalopathy

26
Q

Was is the only diagnosis for chronic traumatic encephalopathy?

A

histopathology after death :(

27
Q

T/F: Higher incidence of mild cognitive impairment and depression in former NFL players with concussion compared to those without

A

True :(

28
Q

Are there guidelines for permanent disqualification due to a concussion?

A

no

29
Q

How to prevent concussions?

A

enforce rules, fair play
helmets do prevent injury, but do not reduce or prevent concussions
mouth guards don’t help w concussions either

Block 7 Week 5 (8 decks)

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