Concussion

Question 1

MOI - impact and non-impact

Answer 1

Impact - rapid decal of brain against skull

Non-impact - rotation injuries (may cause axonal injuries and be more substantial than regular concussion)

Question 2

Categories

Answer 2

Cognitive - reaction time, processing speed
Emotional/Neurobehavioral - abnormal reactions (outbursts, crying, laughing)
Sleep
Migrainous

Question 3

Injured Neuron Function

Answer 3

• cells depolarize too much (K leaves and Ca enters)
• excess Ca sequesters mitochondria = dec ATP
• decreased cerebral blood flow

Question 4

SAC

Answer 4

memory, concentration balance

discontinue if dizziness reported

Question 5

Neurological Testing

Answer 5

• CN (eye movements, pupillary reactions, shoulder/chin strength, balance, RAMs
• UE/LE derm/myo
• VOMS
• SCAT3

Question 6

Symptom Management

Answer 6

• brain will recovery on own
• avoid narcotics, continue with ADD/ADHD meds
• sleep (take naps; melatonin helps fall asleep, benadryal stays asleep)
• minimize exposure to stimulus (bright lights, crowded areas, screens)
• eat and sleep at same times (“grandma lifestyle”)

Question 7

RTP (Zurich)

Answer 7

• Symptom resolution
• Normal neuro exam
• Neurocognitive tests returned to baseline (imPACT results) - verbal, visual, visual motor speed processing, reaction time
• Exertion - graduated physical activity with no return to symptoms

Question 8

RTP (Physical)

Answer 8

• No activity
• Light aerobic exercise (walk, stationary bike, HR < 70% HRmax)
• Sport specific activity - aerobic activity and resistance training
• Non-contact training - complex drills, increase coordination, cognitive load
• Full contact practice - regain confidence
• Gameplay