Mild Traumatic Brain Injuries

• Concussions
• What is a Concussion?
  • A mild brain injury resulting from a direct blow to the head resulting in physiological changes in brain function
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  • Causes
  • Hitting your head
  • Being hit in the head
  • Rapid acceleration/deceleration where the brain ricochets in the skull – whiplash
  • Blast waves from explosions
  • S&S
  • Can be grouped into 4 subcategories:
    • Physical Symptoms
    • Headaches
    • Visual problems
    • Dizziness
    • Noise/Light sensitivity
    • Nausea
    • Cognitive Symptoms
    • Attention problems
    • Memory dysfunction
    • “Fogginess”
    • Fatigue
    • Cognitive slowing
    • Emotionality
    • More Emotional
    • Sadness
    • Nervousness
    • Irritability
    • Sleep Disturbance
    • Difficulty falling asleep
    • Sleeping less than usual
• Amnesia
• Retrograde – Can’t recall events preceding the trauma
  • Question about date, score, location, play, breakfast
• Anterograde – Can’t recall events that occurred after event
  • Question about impact, coming off field
• Retroanterograde – Reversing/confusing order of events
• Why Are Concussions so Dangerous?
• Survivors are often unaware of their injury
• Willingness to report
• Immediate diagnosis of a concussion is based on self-report
• An athlete who sustains a concussion is 4-6 times more likely to sustain a second concussion
• Second Impact Syndrome and Chronic Traumatic Encephalopathy (CTE)
  • Second Impact Syndrome
  • Occurs in athletes with prior concussion following relatively minor second impact
    • Second impact has been shown to occur up to 14 days post-injury
  • Athlete returns to competition before resolution of symptoms
    • Catastrophic increase in intracranial pressure
    • Vasomotor paralysis, edema, massive swelling, herniation, death
  • Chronic Traumatic Encephalopathy (CTE)
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  • Multiple head injuries affect neurological functioning
  • CTE is characterized by the build-up of a toxic protein called tau
  • The build up of these proteins cause behavioral, psychological, and physical changes, including emotional lability and anger issues
• Treatment of a Concussion
• The best way to prevent problems with concussion is to manage them effectively when they occur
• Immediate removal from activity
• Educate your athlete
• Referral to physician
• No athlete should return to play while experiencing symptoms of concussion
• Follow your institutions return from concussion protocol: ImpACT, Standardized Assessment of Concussion (SAC), etc.
• Recovery Time
  • (Time vs Memory)
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  • (Time vs. Reaction Time)
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