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29 Cards in this Set
- Front
- Back
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T/F There is no gold standard for diagnosis of concussion
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True
Also no approved treatment, prescription |
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T/F A concussion is caused by a direct blow to the head
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False - can be impact elsewhere where force is transmitted to the head
also location of injury may be different than the location of impact |
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A concussion is...
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A brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces
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T/F CT and MRI can be used to detect concussion.
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False - no structural injury as far as we know, only functional, so cannot be seen on standard neuroimaging studies
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T/F Concussion does not have to involve a loss of consciousness.
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True
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Concussion involves injury to what neuronal structures?
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Axons (white matter)
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Describe the "metabolic crisis" that occurs in concussion.
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The membranes of the damaged axons become leaky - leach out K+ and glutamate, Ca2+ rushes in which can damage mitochondria; ion pumps use energy to restore the equilibrium, causing a mismatch between supply and demand of glucose in the brain
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In reference to this metabolic crisis, why is it important to avoid re-injury?
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Axons are extremely vulnerable to damage during this period of metabolic crisis
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About how long does it take to return to normal metabolic balance after concussion?
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6-10 days
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An subacute assessment is made where?
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Outpatient clinic
acute: sideline, training room, ED |
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How is a concussion diagnosed?
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Clinical assessment
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What is the biggest distraction when trying to make a concussion diagnosis?
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Athletes hiding symptoms and avoiding the diagnosis so they can play
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What are some questions asked in a quick assessment?
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-Rule out C-spine injury
-Do you remember what happened? -Headache? -Vision blurry? -Dizzy? |
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Ideally where would you like to do the acute assessment?
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training room or away from the sidelines
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What is the most common concussion symptom on the sideline?
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Headache
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What symptom when reported on the sideline suggests the individual will have a longer return to play time?
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Dizziness
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What symptom when reported at a subacute visit (~3 days after incident) may indicate longer return to play time?
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Feeling of fogginess
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T/F Loss of consciousness at time of injury is correlated with longer return to play time.
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False - no effect of RTP
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What exam should you perform on a patient with a suspected concussion?
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Head and neck, neurological
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What is the best practice we have at the moment to detect concussion and improvement?
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Comparison to baseline concussion battery
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What is the name of the concussion test tool used acutely at UF?
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SCAT 3 (Sports Concussion Assessment Tool)
Consists of: Post-Concussion Symptom Scale (PCSS), Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS) |
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The component of the test that assesses concentration, memory and mental status is called what?
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SAC
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The component of the test that tests balance in 3 different positions is called what?
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BESS
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What is the typical management for concussion?
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-Protect from further injury/aggravation
-Serial evaluations until tests are back to normal |
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T/F Concussion symptoms can become more severe over time.
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True - sometimes symptoms worse that night, or next day, two days out
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T/F Males are more at risk for prolonged/severe concussion than females
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False - females more at risk
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What are some risk factors for prolonged/severe concussion?
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-previous concussion
-younger age -female -migraine history -motion sensitivity/ocular dysfunction -learning disability/ADHD -psychological disorder hx |
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T/F Athletes at the high school level cannot return to play the same day of a concussion, but professional athletes may.
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False - no same day RTP at any level
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90% of symptoms of concussion resolve in ____ days.
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7
-still no standardized RTP guideline/timeline |
