Week 4 Highlights

Question 1

what happens at a cellular level after a cerebral concussion

per Giza article

Answer 1

complex neurometabolic cascade of ionic, metabolic, and physiologic events

Question 2

what did a phase-contrast angiography show in 11-15yos s/p concussion at 3days, 2wks, 30 days

Answer 2

3 days - significant reduction in blood flow

2wk - 27% returned to w/i 10% of control’s blood flow

30 days - 64% returned w/i 10% of control

Question 3

what is the most prevalent sx 0-7days post-concussion

Answer 3

HA

Question 4

concussion/mTBI

what are 6 factors predictive of recovery

Answer 4

amnesia
migraine hx
prior concussions
fogginess
dizziness at time of injury
mood disorder

no 1 definite predictive factor, multiple need to be considered

Question 5

concussion/mTBI

what is the primary factor predictive of protracted recovery time and post-concussion syndrome >6xs more likely

Answer 5

dizziness at time of injury

Question 6

concussion/mTBI

what is dizziness present 1-2 weeks post injury predictive of

Answer 6

more likely to have persistent PCS

Question 7

concussion/mTBI

how does a sensory mismatch of balance sensory systems present in this pt pop and which systems

Answer 7

impaired postural control d/t altered visual and somatosensory input

Question 8

concussion/mTBI

what is a major limitation of the BESS test

Answer 8

limited clinical utility beyond 72 hrs from injury

Question 9

concussion/mTBI

what changes to the BESS test is there growing evidence to support? what is a limitation of this?

Answer 9

• integration of dual task in both assessment and training
• no norms or cutoff scores established to support dual task paradigms

Question 10

concussion/mTBI

what is the VOMS a brief clinical screening tool for

Answer 10

vestib and ocular motor impairments and sx after sport-related concussions

Question 11

concussion/mTBI

what do you do with info from a (+) VOMS

Answer 11

if suspected impairment in vestibular, ocular motor, or more central issue -> more specific ocular and vestibular testing is indicated

Question 12

concussion/mTBI

what is convergence

Answer 12

ability to view near target w/o double vision

Question 13

concussion/mTBI

what is the normal near point of convergence as tested on VOMS

Answer 13

<6cm

Question 14

concussion/mTBI

what is a clinically useful cut off scores on the VOMS and waht does this mean

Answer 14

sx scores > or = to 2 on any item and/or > or = 5cm NPC
* inc likelihood of concussion (94%)