1. Head Injuries

2. Objectives  Know the difference between concussion, countercoup concussion, & second impact syndrome  Differentiate the grades of concussions based upon their symptoms  Recognize postconcussion/secondary problems

3. Brain Injuries Closed head injuries = common  Medical, neurological & psychological consequences some serious Brain = one of the most vascular organs in the body  Constant blood and oxygen is needed Result from direct & indirect trauma

4. Brain Injuries “Concussion” = agitation or a shaking of the brain from being hit Countercoup concussion  Brain moves in the fluid surrounding it and is contused by the opposite side of the skull

5. On-the-Field evaluation & emergency care Represents a potentially life- threatening situation If unconscious, a neck injury is always assumed Evaluate before moving Refer to physician  Mild concussion initially can progress to serious condition

6. Further evaluation Testing eye signs  Equal pupils  Vision – blurred, double, sensitive to light  Reaction to light  Tracking Balance Recall – short and long term  100-7  months of the year  5 words  number sequencing  orientation to person/place/time

7. Concussion Grading Scale Grade 1 – Mild  Most common  Minimal symptoms  Dazed, disoriented, no amnesia  “bell rung”  Returns to normal status in 10-15 minutes

8. Concussion Grading Scale Grade 2 – moderate  Unconsciousness lasting less than 5 minutes  Confusion Posttraumatic amnesia – inability to recall events since an injury Unsteady, nausea, tinnitus, dizzy, headache Evaluated by a physician

9. Concussion Grading Scale Grade 3 – Severe  Unconscious for at least 5 minutes  Transport to a hospital on a spineboard  Rule out spinal & skull fractures, internal bleeding

10. Second Impact Syndrome Occurs when as athlete receives a 2nd concussion before an initial concussion has full resolved Brain rapidly swells causing a herniation of brain tissue Potential for death within 15 seconds – 1 minute

11. Postconcussion Problems Numerous complaints  Impaired memory, lack of concentration, tension, irritability, lightheadedness, fatigue, depression, visual problems  Requires referral

12. Secondary conditions Brain swelling (cerebral edema)  Localized swelling at the injury site  Occurs usually within 12 hours & may last up to 2 weeks  Not related to the intensity of the trauma Post injury epilepsy & seizures  Can occur immediately  Higher incidence when the brain is contused or with internal bleeding

13. Secondary conditions Posttraumatic headaches  Mild to severe  Following a single incident of repeat trauma  Stem from physical effort  Often accompanied by nausea & vomiting

14. Return to Play Free of symptoms Determined by a physician

15. Real life consequences http://msn.foxsports.com/nhl/story /george-parros-montreal-canadiens- slams-face-ice-stretcher- hospitalized-colton-orr-toronto- maple-leafs-100113 http://msn.foxsports.com/nhl/story /george-parros-montreal-canadiens- slams-face-ice-stretcher- hospitalized-colton-orr-toronto- maple-leafs-100113 http://www.youtube.com/watch?v= f0xJT53SZqQ&feature=related http://www.youtube.com/watch?v= f0xJT53SZqQ&feature=related http://www.youtube.com/watch?v= jH867uCahEE http://www.youtube.com/watch?v= jH867uCahEE