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