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Concussion Injury

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Kylie S

on 6 December 2013

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Transcript of Concussion Injury

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Overview
Definition
Signs & Symptoms
Educate athletes, coaches, and parents about concussions & the permanent damage it can cause.
Stable relationship between ATs & athletes.
Make sure athletes are asymptomatic before they return to play. (Guskiewicz. K)
Every concussion needs an individualized approach (Guskiewicz. K)
Do not solely rely on one assessment tool
Document everything!! (Miller. J)
Occurrence
Differential Diagnosis
About 1.6-3.8 million concussions occur in collegiate sports every year. (NCAA)
Approximately 85% of those concussions go undiagnosed. (American College of Sports Medicine)
Occurs more often in high intensity sports. (Gessel. L)
Works Cited
"When in doubt sit them out"
Mechanism of Injury
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differential diagnosis
Second Impact Syndrome
Athlete experiences a second concussion after returning to play too soon (Zeigler)
4-6 more times likely to have one (Guskiewicz et al)
Migraines
Subdural & Epidural Hematoma
Depression
Constant throbbing pain on one part of the head
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Buildup of clotted blood from head injury
Epidural: above dura mater
Subdural: beneath dura mater (Cordingly. G)
Change in mood (motivation, attitude, personality)
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Krystal Dionio & Kylie Sakino
CONCUSSION
INJURY

AT 193
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Assessment Tools
MRI & CT*
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Implications for Medical Professionals
Cognitive rest
Avoid test messaging and video games
Limit television and computer use
Decrease schoolwork (Scorza. K)
Physical rest
Refrain from aerobic exercise, lifting weights, household chores (Scorza. K)
No alcohol
No anti-inflammatory drugs
May mask symptoms
Avoid loud & bright places
Alert school personal of injury and initiate slow reintegration (Scorza. K)
Possible need for accommodations (504 plan, IEP)
Prevent re-injury (ImPACT)
Assess symptoms daily
Management
No activity, complete rest
Light aerobic exercise (ex. walking/stationary bike)
Sport-specific activity (no contact)
Non-contact training drills (no contact)
On-field practice (body contact, close monitoring)
Return to play (ImPACT)
Return to Play Protocol
Step 1
Step 2
Step 3
Step 4
Step 5
Step 6
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Concussions cannot be identified or diagnosed by neuroimaging techniques. (McCroy)
Only for more serious traumatic brain injury (TBI)
Clinical Questions
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("when in doubt, sit them out!")
When should an athlete see a concussion specialist?
For athletes with concussion, what interventions can enhance recovery & reduce brain damage?
Test Questions
Answers
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1) Headaches, dizziness, double vision, confusion, disorientation 2) FALSE 3) FALSE 4) Second Impact Syndrome, migraines, depression, subdural or epidural hematoma 5) What is the score? Where are we? Do you know what happened in the last play?
Symptom Checklist
Neuropsychological Tests
Postural Stability Testing
Sideline Assessment Tools
Post-concussion Symptom Scale
Graded Symptom Checklist
Written
Computer-based
ImPACT
Balance Error Scoring System
Sensory Organization Test
Standardized Assessment of Concussion
Sport Concussion Assessment Tool 3
(Scorza. K)
Any sign of neurological damage

When symptoms are steady for 3-5 days
-increased headache
-repeated vomiting
-seizures
-numbness
-excessive crying
-change in sleep patterns & eating habits
-slurred speech (McCroy)

Prevents further damage
Allows appropriate management of the injury
Decreases the chance of Second Impact Syndrome
Allows for long-term monitoring of symptoms
Helps to determine the athletes' rate of improvement or deterioration
1. Return to school 2. Return to play
1. List 4 common concussion symptoms.
2. True/False: Can a MRI/CT scan be used to detect a concussion?
3. True/False: A concussion can only occur with a direct MOI.
4. Name 2 diagnosis that concussions can be mistaken for.
5. What are common questions to ask athletes to see if they have a concussion?
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American College of Sports Medicine (ACSM): “Concussions: ACSM Issues Recommendations for Diagnosis, Treatment and Prevention,” Press Release, June 2, 2006.
Barton, Lindsay. Balance Error Scoring System: Important Tool in Assessing Concussion. 2012. <http://www.momsteam.com/health-safety/BESS-balance-error-scoring-system-assessing-balance-in-concussion>.
Cordingly, Gary. Epidural & Subdural Hematomas: Dangerous Blood Clots on the Brain. 2006. Web. 25 April 2013. http://www.cordingleyneurology.com/epiduralsubdural.html
Guskiewicz. K, Bruce. S, Cantu. R, Ferrara. M, Kelly. J, McCrea. M, Putukian. M, McLeod. T,. "National Athletic Trainers’ Association Position Statement: Management of Sport- Related Concussion." Journal of Athletic Training 39.3 (2004).ImPACT. Sports Injuries, Medicine and Injury Treatment. 2013. <http://impacttest.com/concussion/overview>.
Maurer, Richard, DR. "Coastal Natural Health: The 3 Most Important Natural Therapies Post Concussion." Coastal Natural Health: The 3 Most Important Natural Therapies Post Concussion. Coastal Naturopathic Center, 27 Mar. 2012. Web. 28 Apr. 2013. <http://www.coastalnaturalhealthblog.com/2012/03/3-most-important-natural-therapies-post.html>.
McCroy P, Meeuwisse WH, Aubry M,. "Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012." British Journal of Sports Medicine (2013): 12.
Meehan III, William P. "Medical Therapies for Concussion." Clinics in Sports Medicine 30.1 (2011): 115-6. Print.
Miller. J, Wendt. J, Potter. N. "Implications for Concussion Assessments and Return-to-Play Standards in Intercollegiate Football: How Are the Risks Managed?" Journal of Sport Administration & Supervision. <http://quod.lib.umich.edu/j/jsas/6776111.0003.116?view=text;rgn=main>
National Collegiate Athletic Association (NCAA). "Concussion or Mild Traumatic Brain Injury (mTBI) in the Athlete." 2011-12 NCAA Sports Medicine Handbook. National Collegiate Athletic Association, n.d.Pfeiffer. R, Mangus. B. "Concussion (Mild Head Injury)." Pfeiffer. R, Mangus. B. Concepts of Athletic Training. Jones & Bartlett Learning, n.d.Saffary. R, Chin. L, Cantu. R. "Sports Medicine: Concussions in Sports." American Journal of Lifestyle Medicine 6.2 (2011).
Scorza, Keith A., MD, MBA, Meghan F. Raleigh, MD, and Fracis O'Connor, MD, MPD. "Current Concepts in Concussion: Evaluation and Management." American Family Physician. AAFP, 15 Jan. 2012. Web. 28 Apr. 2013. <http://www.aafp.org/afp/2012/0115/p123.html>.
Stetka, Bret, MD, and Andrew Wilner, MD. "New Concussion Guidelines: An Analysis." Medscape News. Medscape Neurology, 17 Apr. 2013. Web. 28 Apr. 2013. <http://www.medscape.com/viewarticle/782407_4>.
Education regarding the typical recovery process for a concussion. (Meehan. W)
Intervention group showed improve symptoms & shorter recovery times.
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Introduction
A concussion is a bump, blow or jolt to the head, neck, face or body causing a functional disruption in the brain.
Direct-
Blow to the head
Coup
vs.
countrecoup
injury
Indirect-
Blow to other areas of the body
face, jaw
(Pfeiffer.R)
Coup
Contrecoup
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Plenty of hydration & healthy nutrition (Maurer. R)
Brain damage can occur due to fluid and mineral disruptions that provide the brain nutrition and metabolism.
Benefits:
(Saffary. R)
Full transcript