Concussion Flashcards
(17 cards)
Concussion definition
A traumatically induced, temporary disturbance in brain function
Mechanism of a concussion
Caused by a sudden acceleration of the brain within the skull
May occur with or without direct impact
The brain is soft and mobile, making it vulnerable to movement related injury
Contrecoup injury
Occurs opposite the site of impact
Caused by the brain bouncing back inside the skull after the initial blow
Results from the brains momentum continuing after the skull stops
Visual signs of concussion
Clutching head
Unsteadiness, loss of balance
Lying motionless
Seizure
Signs of possible skull fracture
Clear fluid or blood from the ear or nose
Visible swelling or dent in the skull
Bruising around the eyes or behind the ears
Symptoms of concussion
Headache, dizziness, mental clouding, confusion, pressure in the head, visual problems, nausea, fatigue, drowsiness, sensitivity to light, difficulty concentrating
Amnesia
Often occurs after loss of consciousness and affects memory before and after the injury
Retrograde amnesia
Trouble recalling events before the injury
Common due to interrupted memory function
Typically effects minutes to hours before the incident
Anterograde amnesia
Difficulty forming new memories after the injury
Out of character behaviour, wandering, quietness
Post concussive syndrome
When a concussion is not well managed, and an individual experiences another concussion while not completely recovered, chronic condition
Post concussive syndrome cognitive symptoms
Difficulty concentrating, difficulty remembering new info, difficulty thinking clearly, feeling slowed down
Post concussive syndrome physical symptoms
Dizziness, fuzzy vision, headache, nausea, tires, balance problems, sensitivity to light and noise
Post concussive syndrome emotional symptoms
Irritability, nervousness, sadness, more emotional
Post concussive syndrome sleep symptoms
Sleeping more than usual, trouble falling asleep, sleeping less than usual
Return to play - Lancaster et al (2016)
24 hours post -
Significant differences in symptoms and cognitive performance between concussed athletes and control group
1 week post -
No significant differences in symptoms or cognitive tests
MRI still shows significant differences, and these changes are more widespread
Athletes may not be fully physiologically recovered even a week after a concussion
Return to play - Kleiner et al (2018)
Return to play assessments typically use cognitive and physical tests under non-challenging conditions, which may miss subtle changes
Dual task paradigm:
- tests both cognitive and motor skills simultaneously to better assess recovery
CONCLUSION = there are no clear clinical guidelines yet, but studies suggest caution is essential for return to play decisions
Sport Scotland guidelines on return to play
Immediate management -
Do not leave someone with a suspected concussion alone for 24 hours
Avoid alcohol and driving
Ongoing management -
Rest period 24 to 48 hours
Gradual return to normal life should come before sports
Six stage return to sport -
Light exercise —> non contact training —> full return to play
