RN

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
    • 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)
    • (Time vs. Reaction Time)