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AND 2 N D IMPACT SYNDROME
Concussions
Sports Hardest Hits
https://www.youtube.com/watch?v=v-1MQ0Cnbhs
Anatomy of the Brain
The brain is divided into lobes: Occipital Temporal Parietal Frontal
Brain attaches to spinal cord at Brain Stem Via crossover: right side of brain controls left side of
body. Vice versa
Lobes and Their Functions
Anatomy of the Skull
Brain is protected by the skull Comprised of 28 bones
Meninges
Brain is also protected by MeningesMeninges – the three membranes (the dura
mater, arachnoid, and pia mater) that line the skull and vertebral canal and enclose the brain and spinal cord
Contains Cerebrospinal Fluid (CSF) bath the brain and spinal cord in chemicals for proper
function. Maintains/regulates pressure around the brain Helps protect brain from impact
CENTER FOR DISEASE CONTROL AND PREVENTION (CDC) EST IMATES 1 TO 3
MILLION SPORTS -RELATED CONCUSSIONS OCCUR ANNUALLY IN THE US. UP TO 85% GO
UN-REPORTED.
6 HIGH SCHOOL FOOTBALL DEATHS HAVE OCCURRED IN 2015 SINCE SEPTEMBER
2015
Statistics
What is a Concussion?
• A concussion is a short-lived Mild Traumatic Brain Injury caused by a
bump, blow or jolt to the head, that jars or shakes the brain inside the skull
Risk Factors
Athletes with a history of previous brain impairment
Younger athletes whose brains aren’t fully developed (pre-pubescent)
Recent or previous concussion
Poorly fitting or improper equipment
Poor technique Neglect of sports’
rules
Signs and Symptoms
Physical Headache Fuzzy or blurry vision Nausea and vomiting Dizziness Sensitivity to light
or noise Balance problems Fatigue
Cont’d
Emotions and mood Easily upset or angered Sad Nervous or anxious More emotional
Cognitive Not thinking clearly Feeling slowed down Not being able to concentrate Not being able to remember new information
Sleep Patterns
Grading A Concussion
Grade 1: symptoms last for less than 15 minutes. There is no loss of consciousness (LOC).
Grade 2: there is no loss of consciousness but symptoms last longer than 15 minutes
Grade 3: the person loses consciousness, sometimes just for a few seconds, potential for vomiting
Treatment (Tx)
Immediate rest – Absolutely no activity No T.V. No video games No reading No Texting No Driving
Mental activity can make worsen symptoms and prolong recovery
Moderate activity may now be recommended
Tylenol (only) for painSee NeurologistImPact Test if applicable
Return to Play
NEVER return to play if still symptomaticDepending on severity of concussion, may
take days to several weeksOnce the signs and symptoms of a concussion
have resolved: gradual stepwise exertion (such as light aerobic
training) is started. Athlete can then move on to sport specific training. Non-contact drills are followed by full-contact drills,
and, if no symptoms appear, a return to competition
2nd Impact Syndrome
A condition caused by a second concussion occurring before the first concussion has properly healed, causing rapid and severe brain swelling and often catastrophic results. Second impact syndrome can result from even a very mild concussion that can occur days or weeks after the initial concussion or even in the same game.
http://wn.com/second-impact_syndrome
Signs and Symptoms
Severe headacheDilated pupilsLoss of ability to communicateRespiratory failureLoss of eye movementLOC
Tx
Rush to ER Medically induced coma until brain heals Remove portion of skull Physical/cognitive/ Activities of Daily Living (ADL’s)
Therapy
Diagnosis of a Concussion
Signs and SymptomsStandard Assessment Concussion Test – SCAT
2King Devick (KD) Test – must have baselineImPact follow-up testing
Concussion Tests
AVPU – Alert, Verbal, Painful stimuli, Unresponsive
ImPACT – establishes baseline for cognitive function
SCAT2 – subject test based on symptomsKing Devick – objective test based on
reading/comprehensionBalance/FTN test (finger to nose)Many others
Women and Concussions
More ProneEtiology:
Unknown Larger pool ? Weaker musculature?
Prevention?
EducationModification of techniqueStrengtheningAwareness
Other Head Injuries
Skull Fracture Suspected after significant blow to skull Discoloration called Battle sign EVERY skull is significant and must be evaluated by
physicianIntracranial Hematoma
Sever bleeding in the brain Caused by blunt force trauma Signs and Symptoms
Increased BP Drop in pulse rate
Active EMS immediately
What you need to know for the exam
What a concussion isWhat are the signs and symptomsHow to care for a concussionWhat Second Impact Syndrome isWhat are some tests used to diagnose a
concussion
In class…
Practice KD TestPractice the SCAT 2Ch. 5 Worksheet