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Flashcards in TBI - Concussions Deck (16):

What is a concussion. What is it caused by? What does this result in? 

•Concussion is a Mild Traumatic Brain Injury (mTBI)
•Caused by physical forces that bump, blow or jolt the brain.
•This can cause a chemical imbalance, interfering with nerve signal transmission
•Can ultimately change the way your brain works
•There is no test to prove diagnosis of concussion
•Every brain is different, every injury is different, every concussion is different


Which sports have the most concussions?


  • ¡Football
  • ¡Girls Soccer
  • ¡Boys Soccer
  • ¡Girls Basketball
  • ¡Wrestling
  • ¡Boys Basket Ball
  • ¡Softball
  • ¡Gender: Girls suffer more concussions in general, more severe symptoms, and longer recovery time 


What are the risk factors for concussions?

¡Factors that increase likelihood of concussion:

  • ¡Previous Concussion
    • ¡1 previous concussion are twice as likely to have a second
    • ¡2 previous concussions are up to 4 times as likely to have another
    • ¡3 previous concussions are up to 9 times as likely to have another
  • ¡Activity Level
  • ¡Gender:
    • ¡Girls are treated more often for concussions than boys- do they get more or do they report it more?
      • ¡Hormonal factors. Girls less musculature. 


What are the symptoms of a concussion? What evaluations looks for red flags?

•Concussions are diagnosed by their  SYMPTOMS

•ACE- Acute Concussion Evaluation- looks for RED FLAGS


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What are factors that influence severity and recovery?

¡Factor that MAY influence severity and recovery from concussion

  • ¡A history of developmental disorder, psychiatric disorder, or migraines increases recovery time.
  • ¡Sleep/fatigue, dehydration, illness, medications, recovering from a concussion- at time of injury¡


What happens after a concussion? What do most athletes not receive? What does ER examination include?


  • ¡Most athletes will not receive assessment on the sidelines. Will most likely happen in an office or emergency department.
  • ¡Office or ER Examination includes
    • ¡Examination of deteriorating neurological function
    • ¡Physical, cognitive and neurological tests
    • ¡Balance examination


Describe what is done at Head first Sports injury and concussion care

  • ¡Help clients with post-concussion and sports injury care
  • ¡Take Baseline testing- ImPACT
    • ¡Measure neurocognitive function both pre-injury and post-injury
    • ¡Baseline- before injury, to get a sense of how the normal brain functions. 
    • ¡Compares pre injury and post injury results to see which areas are impacted by concussion. 
    • ¡It can also see how a patient progresses week to week by examining each ImPact score report


What are some issues with baseline testing?


  • ¡Many athletes never taken it or take it AFTER concussion, can only examine brain function after it has already been affected- lots of things can be affected. 
  • ¡Not much research done on the effectiveness of baseline testing
    • ¡some doctors don’t use it
  • ¡Results sometimes inconsistent- test retest reliability.
    • ¡Show improvement some days, then decrease in improvement the next day
    • ¡“sandbagging” – purposefully do bad first time.  


Describe the developing brain. Until when do brains develop? Who takes longer to recover and has more severe symptoms?

  • ¡Brains (frontal lobes) continue to develop until the age of 25
  • ¡High School students take longer to recover from concussions that college age athletes
  • ¡High School students have more severe symptoms than college age athletes


What is second impact syndrome?


  • ¡RARE but life threatening
  • ¡Massive, sudden post-concussion cerebral swelling
  • ¡Seems to occur more often in younger athletes
  • ¡Changes in brain after first injury, make the second injury catastrophic


What is post concussion syndrome?


  • ¡Traditional thinking: PCS is diagnosed when concussion symptoms persist beyond 3 months.
    • ¡Headaches, anxiety, depression
  • ¡New recognition that many of the symptoms that persist after the initial recovery period may not be rooted in the actual injury


What is the problem with post concussion syndrome?

  • ¡In some cases, ultra conservative treatment may be the cause of the symptoms.
  • ¡In some cases, the benefits that come with the injury are more advantageous that recovery
  • ¡In some cases, there is a distorted perception of what is normal
    • ¡The good old days effect,  Anxiety sensitivity
    • ¡The solution: Educational Counseling and Cognitive Restructuring


Describe chronic traumatic encepalopathy. What is it? What is it characterized by? In who has it been documented?


  • ¡Degenerative condition that occurs as the result of repeated concussions or possibly sub-concussive blows
  • ¡Characterized by the buildup of a protein in the brain called TAU
  • ¡TAU has been documented in some individuals
  • ¡Behavioral effects of the TAU are less clear


What is the problem with chronic traumatic encepalopathy?


  • ¡In some cases, people have the neuropathology (brain changes) but no symptoms.
  • In other cases, people have the symptoms by no evidence of brain changes.
  • ¡In some individuals, the diagnosis itself can cause the symptoms. 


What does the SLP do?

  • Brain damage in language areas
  • Do a lot of cognitive therapy
  • neurodegenerative disorders


What are the uses of Impact baseline testing?


¡Evaluates neurocognitive functioning

¡Reaction times
¡ Verbal and Visual Memory
¡Attention and processing
¡Long term and short memory
¡Impulse control