Concussions And 2nd impact syndrome
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 Meninges Meninges – 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
Statistics Center for Disease Control and Prevention (CDC) estimates 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
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 Sleep Patterns Emotions and mood Cognitive 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 pain See Neurologist ImPact Test if applicable
Return to Play NEVER return to play if still symptomatic Depending on severity of concussion, may take days to several weeks Once 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 headache Dilated pupils Loss of ability to communicate Respiratory failure Loss of eye movement LOC
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 Symptoms Standard Assessment Concussion Test – SCAT 2 King Devick (KD) Test – must have baseline ImPact follow-up testing
Concussion Tests AVPU – Alert, Verbal, Painful stimuli, Unresponsive ImPACT – establishes baseline for cognitive function SCAT2 – subject test based on symptoms King Devick – objective test based on reading/comprehension Balance/FTN test (finger to nose) Many others
Women and Concussions More Prone Etiology: Unknown Larger pool ? Weaker musculature?
Prevention? Education Modification of technique Strengthening Awareness
Other Head Injuries Skull Fracture Intracranial Hematoma Suspected after significant blow to skull Discoloration called Battle sign EVERY skull is significant and must be evaluated by physician Intracranial 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 is What are the signs and symptoms How to care for a concussion What Second Impact Syndrome is What are some tests used to diagnose a concussion
In class… Practice KD Test Practice the SCAT 2 Ch. 5 Worksheet