Week 4 Highlights Flashcards
what happens at a cellular level after a cerebral concussion
per Giza article
complex neurometabolic cascade of ionic, metabolic, and physiologic events
what did a phase-contrast angiography show in 11-15yos s/p concussion at 3days, 2wks, 30 days
3 days - significant reduction in blood flow
2wk - 27% returned to w/i 10% of control’s blood flow
30 days - 64% returned w/i 10% of control
what is the most prevalent sx 0-7days post-concussion
HA
concussion/mTBI
what are 6 factors predictive of recovery
amnesia
migraine hx
prior concussions
fogginess
dizziness at time of injury
mood disorder
no 1 definite predictive factor, multiple need to be considered
concussion/mTBI
what is the primary factor predictive of protracted recovery time and post-concussion syndrome >6xs more likely
dizziness at time of injury
concussion/mTBI
what is dizziness present 1-2 weeks post injury predictive of
more likely to have persistent PCS
concussion/mTBI
how does a sensory mismatch of balance sensory systems present in this pt pop and which systems
impaired postural control d/t altered visual and somatosensory input
concussion/mTBI
what is a major limitation of the BESS test
limited clinical utility beyond 72 hrs from injury
concussion/mTBI
what changes to the BESS test is there growing evidence to support? what is a limitation of this?
- integration of dual task in both assessment and training
- no norms or cutoff scores established to support dual task paradigms
concussion/mTBI
what is the VOMS a brief clinical screening tool for
vestib and ocular motor impairments and sx after sport-related concussions
concussion/mTBI
what do you do with info from a (+) VOMS
if suspected impairment in vestibular, ocular motor, or more central issue -> more specific ocular and vestibular testing is indicated
concussion/mTBI
what is convergence
ability to view near target w/o double vision
concussion/mTBI
what is the normal near point of convergence as tested on VOMS
<6cm
concussion/mTBI
what is a clinically useful cut off scores on the VOMS and waht does this mean
sx scores > or = to 2 on any item and/or > or = 5cm NPC
* inc likelihood of concussion (94%)
