DEFINITION
SIGNS AND SYMPTOMS
TESTING
MANAGEMENT
CONFOUNDERS and COMPLICATIONS
100
A mild traumatic brain injury causing a disturbance in brain function
What is a concussion?
AKA: mTBI
100
•Headache
•Fatigue
•Dizzy
•Nausea/Emesis
•Photophobia
•Double vision
•Phonophobia
What are the somatic symptoms of a concussion?
100
SCAT6TM
ImPACT Testing
What are examples of in office and sideline concussion testing?
100
Relative (not strict) rest
Includes ADL's and reduced screen time
What is the initial management of a concussion in the first 24-48 hours?
100
•ADHD
•History of migraines
•History of mood disorder
•Learning disorder
•Sleep disorder
What are conditions that can confound testing for concussion?
200
Axonal, biochemical injuries and energy mismatch resulting in increased glucose need and decreased blood flow.
What occurs in the brain after a concussion?
200
Stephen Nedoroscik
Who is Dr. Roulier's favorite athlete of the 2024 Olympics?
200
Women's sport that has the highest inherent risk of sustaining a concussion during a game situation.
What is women's lacrosse?
200
•ABC’s
•Evaluate for cervical spine injury
•Determine need for transport versus stable for observation and off-field assessment
What is the initial assessment after a head injury?
200
•Convulsive motor phenomena
•Posttraumatic seizures
•Second impact syndrome
•Postconcussion syndrome
What are possible complications of a concussion?
300
The women's sport with the highest rate of concussions
What is soccer?
300
•Irritability
•Delayed reaction times
•Drowsiness
•Emotional lability
•Abnormal gait or balance
What are signs of a concussion?
300
a Normal CT Scan
What is the most common finding on ct imaging of a patient with a concussion?
(Therefore it is not a diagnostic test)
300
•Once symptoms have decreased to a safe enough level, one can resume cognitive activity
•As long as it does not worsen symptoms or cause any new symptoms
•Involves gradual resumption of mental activities
When can the patient go back to work or school?
300
•Concussion symptoms that last for weeks to months beyond expected usual time of recovery
•Adults lasting longer than 2 weeks
•Children lasting longer than 4 weeks
•Remember that most concussions resolve in 7–10 days
What is post-concussive syndrome?
400
•Occurs in athletes who are still symptomatic from prior concussion
•Vascular engorgement
•Rapid brain swelling, increased intracranial pressure and herniation
•Usually results in death (up to 90%)
What is Second Impact Syndrome?
400
This sign may occur but is not essential for diagnosis of concussion.
What is loss of consciousness?
400
•Suspicion of cervical spine injury
•Suspicion of intra-cerebral injury
•Prolonged loss of consciousness
•Deteriorating neurological state
•Signs of skull or facial bone fracture
•Focal neurological deficit
What are indications for obtaining imaging studies?
400
•Athlete may proceed to next level when asymptomatic
•Each level takes about 24 hours
•If any concussive symptoms occur, step back one level and re-evaluate in 24 hours
•Athlete should still have full recovery: cognitively and symptomatically
What is a return to play protocol?
400
•Elderly, women and higher impact
What are risk factors for post-concussive syndrome?
500
The latest guidelines for concussion management.
What is the 2022 Amsterdam International Consensus Statatement on Concussion in Sport?
500
A Glasgow Coma Scale of <15
deteriorating mental status
suspected spinal cord injury
Progressive or worsening neurologic symptoms
When is it time to activate the Emergency Response system on the sideline?
500
QxMD
What is a free app that has both the Canadian CT Head rule and the PECARN Decision tree for imaging in traumatic brain injury?
500
•Functional recovery
•Return to normal activities including work/school and sport
•Clinical recovery
•Resolution of concussive symptoms and return to normal balance and cognitive functioning
What is a complete functional and clinical recovery from a concussion?
500
•501-364-4000
What is the phone number for the Arkansas Children’s Hospital Head Injury Clinic?