Concussions And 2nd impact syndrome

Sports Hardest Hits https://www.youtube.com/watch?v=v-1MQ0Cnbhs

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

Lobes and Their Functions

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

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

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

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

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

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

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

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

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

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

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.

http://wn.com/second-impact_syndrome

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

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

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

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

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

Prevention? Education Modification of technique Strengthening Awareness

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

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

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