Traumatic Brain Injury - Kanoff

Question 0

What is the definition of concussion?

Answer 0

Any neurological symptom due to an impulse to the brain

• doesn’t actually need to be direct trauma
• can be turbulent force that shakes the brain and causes damage

Question 1

What does “RAM” stand for in the management of concussions?

Answer 1

R = Restrictions
A = Accommodations
M = Medications (symptom management)

Question 2

How long does the average concussion last?

Answer 2

7-10 days

Question 3

How long after a concussion is a person at high risk for addition concussion? Why?

Answer 3

10 days

Reduced reaction time, spatial awareness, and concentration.

Question 4

What is the main goal in managing a concussion with restrictions?

Answer 4

• prevent new injury during recovery
• avoid risk taking
• progression to play

Question 5

What is the most important aspect in the management of concussion symptoms?

Answer 5

Close follow up

Question 6

What are some possible treatments in the management of concussion symptoms?

Answer 6

• anti-migraine therapy
• antiemetics
• anti-vertiginous agents
• anti muscle spasm
• sleep aid
• anti-anxiety

Question 7

What does MN Statute 121A.37 say about school athletic programs/organizations that charge fees for athletes 18 year and younger during practice and training?

Answer 7

Anyone “suspected” of having a concussion must be removed from play and require a written release note from a provider to return to play.

Question 8

What is one side line test administered to detect potential head trauma that involves a series of cards where words get spread out and off set in order to test visual tracking, reading, and complex tasks involving many parts of the brain working together and coordinating messages?

Answer 8

King-Devick

Question 9

Where does brain atrophy start occurring in professional boxers?

Answer 9

Starts in thalamus, also happens in amygdala

Question 10

What is the pathophysiology behind a concussion?

Answer 10

Disruption of cell function - ion channels leak.

• Calcium influx
• Cell dysfunction and damage
• Causes inflammatory response
• Axon disruption from the nerve cell
• Capillary disruption from the capillary network (micro bleeds)
• Energy mismatch, glucose not able to reach certain cells

Question 11

What is the definition of post-concussive syndrome according to Dr. Kanoff?

Answer 11

Persistent symptoms referable to concussion, lasting beyond one month.

Question 12

What is the difference between post-concussive syndrome and CTE?

Answer 12

• PCS = linked to discrete concussive event, symptoms wax/wane/resolve, non-progressive
• CTE = symptom-free interval with relatively high physical and cognitive functioning, progressive decline over years/decades

Question 13

Is it possible that some people become unafraid of committing suicide?

Answer 13

Athletes may

-damage to amygdala wipes out fear of risky behavior

Question 14

What is the recommendation on how many concussions is too many?

Answer 14

-4 concussive events within 4 years (each with symptoms lasting at least 7 days - assumes full recovery)

OR

-3 or more concussive events with progressively increasing deficits by BOTH duration and severity (assumes full recovery)

Question 15

What is a post-traumatic headache?

Answer 15

severe headache that occurs beyond 2 months post injury