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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