Case Study of Concussion By: Michael Cox Clinic II

History 17 year old male football player Made helmet to helmet contact while covering a punt Once struck, fell to the ground lying supine in a decorticate position 17 year old male football player Made helmet to helmet contact while covering a punt Once struck, fell to the ground lying supine in a decorticate position

Evaluation Athlete was unconscious upon arrival but regained consciousness (total 45sec) Transient confusion, began to seizure Once we repositioned him we removed the facemask Proceeded to spine board, during this his level of consciousness improved Signs and symptoms: the athlete complained of headache, wasn’t very responsive. Palpations: athlete did not have any point tenderness in neck Range of motion and special tests were not performed Athlete was unconscious upon arrival but regained consciousness (total 45sec) Transient confusion, began to seizure Once we repositioned him we removed the facemask Proceeded to spine board, during this his level of consciousness improved Signs and symptoms: the athlete complained of headache, wasn’t very responsive. Palpations: athlete did not have any point tenderness in neck Range of motion and special tests were not performed

Diagnosis  Differential diagnosis: Cervical cord trauma Fractured vertebrae Dislocated vertebrae Concussion  Diagnosis: Grade III Concussion  Differential diagnosis: Cervical cord trauma Fractured vertebrae Dislocated vertebrae Concussion  Diagnosis: Grade III Concussion

Rehab and Return to Play Criteria  Released from hospital same day  Returned to school the following Wednesday- no strenuous thinking  Still had headaches and heavy lighted places bothered him  Ten days after initial injury the athlete began rehab  If any signs or symptoms returned during any activity he was told to stop  Bike for 10min  Bike for 20min  Bike for 20min followed by a lifting program  Bike to warm up, short sprinting, lifting  Bike to warm up, sport specific activities  Practice with no contact  Full participation  Total of 18 days for full participation  First game was 3 weeks from injury  Released from hospital same day  Returned to school the following Wednesday- no strenuous thinking  Still had headaches and heavy lighted places bothered him  Ten days after initial injury the athlete began rehab  If any signs or symptoms returned during any activity he was told to stop  Bike for 10min  Bike for 20min  Bike for 20min followed by a lifting program  Bike to warm up, short sprinting, lifting  Bike to warm up, sport specific activities  Practice with no contact  Full participation  Total of 18 days for full participation  First game was 3 weeks from injury

Uniqueness and Relating to Literature  Still have a lot to learn about head injuries  Spine boarded athlete as a precaution  Proper return to play criteria  Still have a lot to learn about head injuries  Spine boarded athlete as a precaution  Proper return to play criteria

Summary Unconscious athlete on field Spineboard 7 days asymptomatic before activity Gradual progression Full activity Unconscious athlete on field Spineboard 7 days asymptomatic before activity Gradual progression Full activity