Headache / Concussion Flashcards
(40 cards)
What is the most common sports-related TBI?
Concussions
The transient brain dysfunction in concussions is related to the excessive release of what?
Excitatory neurotransmitter release (particularly glutamate)
What are the most common acute symptoms in concussions?
Headache* Nausea Dizziness Confusion Memory impairment Incoordination Attention problems Behavioral changes
T/F: LOC is a requirement for concussion diagnosis
False
It is not a requirement
What would constitute a Grade 1 concussion?
Grade 2?
Grade 3?
Grade 1: - LOC, Sx and amnesia resolve in under 30 minutes
Grade 2: + LOC for less than 1 minute, Sx and amnesia lasting less than 1 week
Grade 3: + LOC for longer than 1 minute, Sx and amnesia for longer than 1 week
Are brain structural abnormalities seen on imaging in concussion patients?
No
When would imaging be warranted in a patient with a concussion?
\+ LOC Focal neural deficits Persistent AMS Skull Fractures 2+ episodes of emesis > 65 y.o. Serious Trauma (MVA, Fall) EtOH Use
What is the most critical portion of concussion treatment?
The first 10 days
Patients with concussions often benefit from ___ hours of direct observation.
4 Hours
Concussion patients should have a follow up visit for neurological check within the first ___ hours of diagnosis.
24 hours
Athletes with a single concussion can return to sports after being asymptomatic for longer than ___ ______.
1 week
If concussion symptoms last longer than 1 year after diagnosis, they are considered to have what syndrome?
Post-concussive syndrome
Would an MRI be warranted if a patient continued to experience concussive symptoms for for longer than 1 year?
Yes (r/o other causes)
What is a complication often associated with concussions?
Chronic Traumatic Encephalopathy
Dementia Pugilistica
Which type of headache is best described below……
Unilateral Pulsating Interferes with ADLs Nausea Photophobia / Phonophobia No Prodrome
Migraine without Aura
Can migraines without aura be related to menstrual cycles?
Yes….
Catamenial Migraines
What is commonly described on an EEG of a patient with migraines?
Cortical spreading depression
T/F: Oligaemia is seen in patients with migraines without aura
False
Oligaemia is seen in patients with migraines with aura
What is the most common aura patients with migraines will experience?
What are examples of these?
Visual
Examples:
Zig-Zag Pattern
Scotoma
Other than visual, what are examples of auras migraine patients may experience?
Sensory Disturbances (ie: pins and needles) Speech Disturbances (Aphsia) Hemiplegic Weakness
Why is it important to have patients document their auras, including onset, presentation, and duration?
This can help distinguish between migraines and CVA
Which type of headache is best described below……
Visual changes lasting 20 minutes prior to resolution with associated tingling in the left arm which resolves prior to the onset of the headache
Migraine with aura
T/F: Migraines can be bimodal
True
What are the top THREE most common migraine triggers?
- Stress
- Hormones (Women > Men)
- Not Eating
Others include….
Weather Sleep Disturbance Odors Lights Alcohol Smoking Exercise
