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)
      *
      * 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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