Concussion Flashcards
Why does the definition of a concussion use the term “impulse” instead of “impact”?
Because you don’t need to hit your head to have a consussion - acceleration/deceleration injuries can cause them as well
What are the common symptoms you’ll see in concussion?
headache, nausea, vertigo, fogginess, difficulty reading, difficulty concentrating, mood issues, withdrawn
symptoms worse with activity and stimulation - light sound and motion
WHat are sort of three reasons why a concussion patient can develop a depression
- it can be a chemical response to the trauma
- it can be a social reactive response to the fact that they’ve had to stop activity
- chronic pain from headaches can also lead to a depression
DUring what time frame after a concussion do you become more prone to a 2nd concussion> Why?
for the following 10 days
this is because the 1st concussion likely slowed reaction time, altered spatial awareness, and impaired concentration - these all make you more prone to a second injury
How long does the average concussion last?
7-10 days
What is the emergent condition that can occur after a concussion
more specifically after the SECOND concussion in a short period of time - second impact syndrome, where the injured brain swells dramatically - this is malignant intracranial hypertension
According to MN Law, what is a coach’s responsibility in concussion?
Groups that have sports for which people have to pay a fee to play must require their coaches to take an online training on concussion every 3 years
plus, if the player signs a consent form to play, there must be information on concussion risk and the rules for when they get a concussion
You are supposed to remove a player from play with both a SUSPECTED and confirmed concussion. When can they return to play?
It varies…
return to play after no symptoms, clearance by a healthcare provider - clearance in writing!
What are the goals in standardized testing for concussion?
- to get a baseline function
- to objectify a deficit in concussion
- to gauge improvement after concussion
What are two options for side line testing of concussions?
the SCAT 2 is long and hard to administer
the King-Devick involves a test of visual tracking with voluntary and involuntary pathways from frontal, parietal, occipital, limbic and brainstem structures
Why do you frequently see “improvement” post concussionon ImPACT testing?
people sandbag the baseline test
The average high school football player receives ___ 20 g hits per season.
900
A study showing steady memory decline in hockey players over the course of the season without frank diagnosis of concussion brought about what controverial idea?
that there may be such a thing as a “silent concussion”
It takes __x as long to recover from a 2nd concussion than it did form the 1st.
2x -found by spect MRI
Who seems to get concussions worse, girls or boys?
girls - may be that the girls are just more honest, or it may be that they have more ligament laxity causing grater force to the brain durin injury
Brain atrophy will start in boxers after how man fights? In what are of the brain first?
after only 15 fights - in the thalamus first
What are the 4 sort of physiological reactions to concussion?
- you have increased energy demand and increased glucos utilization in the injured area = perfusion mismatch
- disruption of ion channel function
- calcium influx
- dynamic fluid changes in the white matter
- changes in the network connectivity
CTE exhibits tauopathy. Where does tau usually live?
it’s usually in the microtubules of axons. when the axons are injured, it can leak out and trigger the brain to lay down amyloid and start an immune response
Where does tau protein deposition usually occur in the brain from CTE?
perivascular, in the amygdala, thalamus and sulcal depths
different from AD because that’s usually closer to the cortex surface
What happens to the BBB in concussion?
it seems to get disrupted somehow - an antibody that blocks the inflammatory changes decreases TBI symptoms
When do you typically give someone the diagnosis of a post concussive syndrome?
when the patient has persistent symptoms beyond 1 month
what might the symptoms of post concussive syndrome actually be?
it could just be a chronic headache disorder that was triggered by the initial concussion
What are Dr. Kanoff’s two basic criteria for advising retirement from sport?
- 4 concussion in 4 years with each lasting 7 days
- 3 or more concussive events with progressive increasing deficits by both duration and severity
