1. Concussions
And 2nd impact syndrome

2. Sports Hardest Hits

3. Anatomy of the Brain The brain is divided into lobes:
Occipital
Temporal
Parietal
Frontal
Brain attaches to spinal cord at Brain Stem
Via crossover: right side of brain controls left side of body. Vice versa

4. Lobes and Their Functions

5. Anatomy of the Skull Brain is protected by the skull
Comprised of 28 bones

6. Meninges Brain is also protected by Meninges
Meninges – the three membranes (the dura mater, arachnoid, and pia mater) that line the skull and vertebral canal and enclose the brain and spinal cord
Contains Cerebrospinal Fluid (CSF)
bath the brain and spinal cord in chemicals for proper function.
Maintains/regulates pressure around the brain
Helps protect brain from impact

8. Statistics
Center for Disease Control and Prevention (CDC) estimates 1 to 3 million sports-related concussions occur annually in the US. Up to 85% go
un-reported.
6 high school football deaths have occurred in 2015 since September 2015

9. What is a Concussion?
A concussion is a short-lived Mild Traumatic Brain Injury caused by a
bump, blow or jolt to the head,  that jars or shakes the brain inside the skull

10. Risk Factors Athletes with a history of previous brain impairment
Younger athletes whose brains aren’t fully developed (pre-pubescent)
Recent or previous concussion
Poorly fitting or improper equipment
Poor technique
Neglect of sports’ rules

11. Signs and Symptoms Physical Headache Fuzzy or blurry vision
Nausea and vomiting
Dizziness
Sensitivity to light or noise
Balance problems
Fatigue

12. Cont’d Sleep Patterns Emotions and mood Cognitive
Easily upset or angered
Sad
Nervous or anxious
More emotional
Cognitive
Not thinking clearly
Feeling slowed down
Not being able to concentrate
Not being able to remember new information
Sleep Patterns

13. Grading A Concussion
Grade 1: symptoms last for less than 15 minutes. There is no loss of consciousness (LOC).
Grade 2: there is no loss of consciousness but symptoms last longer than 15 minutes
Grade 3: the person loses consciousness, sometimes just for a few seconds, potential for vomiting

14. Treatment (Tx) Immediate rest – Absolutely no activity
No T.V.
No video games
No reading
No Texting
No Driving
Mental activity can make worsen symptoms and prolong recovery
Moderate activity may now be recommended
Tylenol (only) for pain
See Neurologist
ImPact Test if applicable

15. Return to Play NEVER return to play if still symptomatic
Depending on severity of concussion, may take days to several weeks
Once the signs and symptoms of a concussion have resolved:
gradual stepwise exertion (such as light aerobic training) is started.
Athlete can then move on to sport specific training.
Non-contact drills are followed by full-contact drills, and, if no symptoms appear, a return to competition

16. 2nd Impact Syndrome
A condition caused by a second concussion occurring before the first concussion has properly healed, causing rapid and severe brain swelling and often catastrophic results. Second impact syndrome can result from even a very mild concussion that can occur days or weeks after the initial concussion or even in the same game.

18. Signs and Symptoms Severe headache Dilated pupils
Loss of ability to communicate
Respiratory failure
Loss of eye movement
LOC

19. Tx Rush to ER Medically induced coma until brain heals
Remove portion of skull
Physical/cognitive/ Activities of Daily Living (ADL’s) Therapy

20. Diagnosis of a Concussion
Signs and Symptoms
Standard Assessment Concussion Test – SCAT 2
King Devick (KD) Test – must have baseline
ImPact follow-up testing

21. Concussion Tests AVPU – Alert, Verbal, Painful stimuli, Unresponsive
ImPACT – establishes baseline for cognitive function
SCAT2 – subject test based on symptoms
King Devick – objective test based on reading/comprehension
Balance/FTN test (finger to nose)
Many others

22. Women and Concussions More Prone Etiology: Unknown Larger pool ?
Weaker musculature?

23. Prevention? Education Modification of technique Strengthening
Awareness

24. Other Head Injuries Skull Fracture Intracranial Hematoma
Suspected after significant blow to skull
Discoloration called Battle sign
EVERY skull is significant and must be evaluated by physician
Intracranial Hematoma
Sever bleeding in the brain
Caused by blunt force trauma
Signs and Symptoms
Increased BP
Drop in pulse rate
Active EMS immediately

25. What you need to know for the exam
What a concussion is
What are the signs and symptoms
How to care for a concussion
What Second Impact Syndrome is
What are some tests used to diagnose a concussion

26. In class…
Practice KD Test
Practice the SCAT 2
Ch. 5 Worksheet