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Neuromuscular Conditions II > Concussion > Flashcards

Concussion Flashcards

1
Q

Concussion

A

-graded I-III

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2
Q

Brain Injury Continuum

A
  • concussion
  • mild brain injury
  • moderate brain injury
  • severe brain injury
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3
Q

Grade I

A
  • conscious but confused

- <15 min

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4
Q

Grade II

A
  • Conscious but has amnesia

- >15 min

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5
Q

Grade III

A

-unconscious seconds or minutes

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6
Q

What happens in concussion

A
  • coup-contrecoup
  • contusions
  • axonal shearing/diffuse axonal injury
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7
Q

Response to concussion

A
  • microglia eat away dead tissue

- inflammation

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8
Q

S/Sx

A
  • headache
  • dizziness
  • NV
  • loss of consciousness
  • difficulty concentrating
  • memory loss
  • change in appetite
  • difficulty sleeping
  • irritability
  • sadness
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9
Q

1/3 concussions from:

A

-sports

other=MVA, falls

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10
Q

Cause of concussion in age 1-2 years

A

-child abuse

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11
Q

adolescent concussion causes (age 15-24)

A

realted to risk-taking behaviors (biking, sports etc)

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12
Q

Elderly concussion cause

A

-falls

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13
Q

Challenges with Elderly

A
  • age-related issues
  • variable baseline cognition and memory
  • comorbidities
  • medication (intrathecal bleeding)
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14
Q

Diagnosis of Concussion

A
  • SCAT 3 (20 min)
  • Maddock’s Question (8 questions)
  • SAC (6 min)
  • BESS (5 min, balance)
  • Canadian CT Head Rule
  • Sports Palm Card
  • Acute Concussion Evaluation Form(ACE)
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15
Q

NFL Sideline Concussion Assessment Tool

A
  • includes baseline test during pre-season
  • given again at time of injury

-based on SCAT-2

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16
Q

Acute Concussion Evaluation

A
  • CDC recommended form for diagnosing concussions

- emergency & physician version

17
Q

Biochemical Markers of Concussion

A
  • circulating proteasome activity in children with mild head injury
  • significant increase after injury
18
Q

Complications

A
  • 2x higher risk of epilepsy w/n first 5 years
  • cumulative concussions: progressive impairments
  • post concussion syndrome
  • Second impact syndrome
  • comvulsive motor phenomenon
  • chronic traumatic encephalopathy
  • Chronic Traumatic Encephalomyopathy
19
Q

Postconcussion Syndrome

A
  • dizziness
  • headaches
  • thinking difficulties

-last up to several months

20
Q

Second Impact Syndrome

A
  • getting a 2nd concussion before 1st has reslolved

- cause rapid and fatal cerebral edema

21
Q

Convulsive Motor Phenomena

A

-benign tonic posturing and/or convulsions immediately after concussion that resolve quickly

22
Q

Chronic Traumatic Encephalopathy

A
  • progressive neurodegenerative disease caused by total brain trauma
  • diagnosed only after death with Tau protein)
23
Q

Chronic Traumatic Encephalomyopathy

A

-motor neuron disease similar to ALS

24
Q

Brain chemistry changes my not resolve for:

A

at least 30 days

25
Q

Second Impact Syndrome can lead to:

A

-massive increase in intracranial pressure and brain herniation–>death

26
Q

Acute Concussion Management

A
  • emergency management
  • clear with onsite HCP
  • clear CS injury
  • SCAT or other assessment sideline
  • assess cognition, CN integrity, balance
  • monitor next few hours/days
27
Q

if it lasts more than 10 days

A

it may indicate more than a mild brain injury (more than concussion)

28
Q

Best Practice

A
  • don’t return to play same day
  • physical/cognitive rest
  • progress to dual-task
  • return to play gradual
  • pt should be asymptomatic and on no meds that may mask S/Sx
29
Q

Progression of Rehab Stages

A

-only progress to next level if pt is asymptomatic for 2 hours

30
Q

Principles of Rehab

A
  • balance
  • neurocognitive retraining
  • reaction training
  • avoid overloading sensory and motor systems
  • maintain postural control during dual tasks
31
Q

Gold Standard For Diagnosis

A

-none

Neuromuscular Conditions II (15 decks)

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