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)
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