Concussion Flashcards
describe concussion
a biomechanical force transmitted to the head (direct or indirect) that causes chemical changes in the brain
T/F: concussion leads to extended periods of LOC, amnesia, and other significant neurological signs of severe brain injury
False
what are the biomechanics that cause concussion
- coup-countercoup
- rotational (worse)
- shearing of axons: DAI
what is a proposed idea for why women are at increased risk of getting concussions
potentially due to weak deep cervical neck flexors
common causes of concussion
sports
MVA
falls
high impact collisions
blunt trauma
blast/military
assault
what is second impact syndrome
when a person sustains a second concussion before healing of initial concussion
- additional swelling to the brain
what are the s/s of second impact syndrome
dilated pupils
loss of eye movements
unconsciousness
respiratory failure
death (within 2-5 minutes)
what are the 6 concussion clinical trajectories
vestibular
oculo-motor
post-traumatic migraine
cognitive
anxiety/mood
cervical
Vestibulo-Ocular Impairments
dizziness, balance problems, vertigo, blurred vision, headaches, nausea, sensitivity to light and sound, mental fogginess, difficulty reading and concentrating, anxiety or fatigue
Cervical MSK Impairments
neck pain, headache with or without neck pain, dizziness, diminished balance or postural control
Autonomic Dysfunction and Exertional Impairments
increased sx with physical exertion, fatigue, deconditioning, orthostatic hypotension
motor function impairments
static and dynamic balance impairments, changes in multitasking impairments, delayed motor reaction time, increased difficulty with motor coordination
what factors can impact concussion recovery
age
sex
hx of concussion
ADHD
Hx of migraine
genetics?
what is the typical duration for recovery after concussion
7-14 days
what factors can be predictors of prolonged recovery
dizziness at time of injury
HA
migraine and depression
what are red flags during concussion eval
GCS < 13
Pupillary asymmetry, repeated vomiting, seizures
Severe or rapidly worsening HA or neuro deficits
Undiagnosed skull fx
Cervical spine fx or ligamentous instability
what is the normal distance for convergence
<6 cm
what does VOMS stand for
vestibulo-ocular motor screen
what are the 5 components of the VOMS
- smooth pursuits
- horizontal and vertical saccades
- convergence
- horizontal and vertical VOR
- visual motion sensitivity
what are the components of King-devick test
saccades, vergence and accommodation based reading assessment
