Concussion Flashcards
tissue death
necrosis
death of the “electrical wires” of the brain
axonal injury
programmed cell death
apoptosis
loss or destruction of the nerve’s myelin coating in the central nervous system
demyelination
presence of microglia (immunological cells) in nervous tissue secondary to injury
microgliosis
regrowth or repair of nervous tissues, cells or cell products
neuro-regeneration
symptoms of concussion
headache feeling slowed down difficulty concentrating dizziness fogginess fatigue visual blurring/double vision light sensitivity memory dysfunction balance problems
key factors related to recovery
Age Exertion Migraine amnesia dizziness repetitive injury
maintains stable gaze at slow speeds
smooth pursuit
differences in tonic firing rate between the vestibular nucleii
spontaneous nystagmus
quick movements of eyes between targets
saccades
maintains fixed gaze with head movements
Vestibulo ocular reflex
small amplitude, quick movement and observe corrective saccades; peripheral sign - UVL or BVL
Head thrust test
move head at the rate of 2 Hz with 30 deg neck flexion and observe nystagmus; horizontal nystagmus - peripheral sign; vertical nystagmus- central sign
head shake test
saccades or nystagmus is a central sign
VOR cancellation
move head at 2 Hz and if patient loses more than 3 lines indicated hypofunction
dynamic visual acuity test
trouble reading, focusing trouble focusing from far to near blurred vision headaches eye strain sensitivity to light pulling sensation around eyes avoidance of reading compression deficits over time
symptoms of vergence system deficits
guidelines for return to play following sports concussion
gradual return to play program should be implemented once the following conditions are satisfied
completely asymptomatic presentation
normal neuro-cognitive evaluation
off medication
