Concussions

By: Nick Elsbury
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Table of Contents

  • Background Information/Definition/Causes

  • Symptoms

  • ImPACT Test

  • Second Impact Syndrome

  • Example of Serious Concussion


Background Information/Causes

A concussion is a type of traumatic brain injury that is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull. "In fact, a concussion is one of eight different types of traumatic brain injuries (TBI) that most commonly result from falls, motor vehicle accidents, sporting accidents and wrongful firearms discharges" (Smayda, 1999). Moreover, a concussion is an immediate, but reversible traumatic paralysis of the nervous function.
Symptoms of a concussion vary from person to person. More so than the immediate impact, a concussion involves effects that emerge several hours or days after the trauma. On the other hand with rest, most people fully recover from a concussion, anywhere from a few hours to a a couple weeks. Repeated concussions or a severe concussion may require surgery or lead to long-lasting problems with movement, learning, or speaking. It is critical for physicians to monitor secondary tissue damages, as they are frequently the origin of significant long-term effects, including brain damage, cognitive deficits, psychosocial/behavioral/emotional changes, bodily damage and biochemical changes at the cellular level (Concussion-, n.d.).


The brain is a soft organ that is surrounded by spinal fluid and protected by your hard skull. Normally, the fluid around your brain acts like a cushion that keeps your brain from banging into your skull, but it is the rotational movements of the brain inside the cranium and the shearing forces affecting the upper reticular formation that create torque, which leads to the typical loss of consciousness. These forces also cause the brain to move in a swirling fashion and contact the inner prominence of the skull, particularly the petrous and orbital ridges and the wings of the sphenoid. Such movement makes the brain bump into the interior of the skull at the point of impact, as well as on the opposite side of the skull, resulting in contusions or bruises that damage two sites in the brain, called the coup and contrecoup injuries (Smayda, 1999). Some common ways of receiving a concussion include fights, falls, car crashes, football, boxing, and hockey.







Symptoms


Signs and symptoms of a concussion can range from severe to mild. Most of the time there are no visible signs of a brain injury, while other times people will have obvious symptoms, such as forgetting what happened right before the injury or losing consciousness. Let’s get this straight; a person does not have to lose consciousness to have a concussion. Symptoms may affect a person physically, emotionally, cognitively and affect one sleep. Symptoms can include:

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  • Balance Problems
  • Vomiting
  • Feeling mentally "foggy"
  • Difficulty remembering information/events
  • Irritability
  • Sadness
  • Drowsiness


Related to College Students

In 2012, there were 453,347 collegiate student-athletes. "By one estimate, 300,000 high school and college athletes a year get concussions" (Hoffman, 2013).As concussions are a growing injury in athletics; many students may be surrounded or even be diagnosed with a concussion. Concussions have a pivotal influence in the brain's ability to function normally. A concussion has significant impact on classroom learning and college schoolwork. Furthermore, a concussion can affect a student in various ways: physically, mentally, emotionally, and by disturbing sleep. Mentally, a concussion affects a student's ability to learn and memorize and process information. On the other hand, symptoms interfere with a student's ability, physically, to focus and concentrate. A concussion causes a change in brain chemistry, which leads to struggles in school work.


ImPACT Testing

ImPACT Testing is computerized exam that takes about 25 minutes to complete in order to measure if a concussion should be diagnosed. The ImPACT program recommends that it be administered by an ImPACT trained athletic trainer, school nurse, athletic director, team doctor or psychologist. Baseline tests are suggested every two years. "The baseline test provides a snapshot of how one’s brain functions in normal, everyday circumstances" (Sports-, n.d.). If a concussion is suspected, the baseline report will serve as a comparison to a repeat ImPACT test, which professionals can use to assess potential changes or damage caused by a concussion. The test modules consist of a near infinite number of alternate forms by randomly varying the stimulus array for each administration in order to minimize the "practice effects" that have limited the usefulness of more traditional neurocognitive tests. The program measures multiple aspects of cognitive functioning in athletes, including: working memory, attention span, reaction time and response variability (ImPACT, n.d.). Post-Injury Testing is usually conducted once a concussed athlete is symptom-free or as early as 24-72 hours, after the injury depending on the clinician managing the athlete’s condition. Post-injury testing composite scores are then compared to the baseline scores to check if the concussion is still diagnosed or not. If post-testing scores have not recovered in sufficient time, usually within 3-4 weeks, the athlete may be referred to a neuro-specialist with advanced training in treating head injuries.






Second Impact Syndrome

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Second-impact syndrome (SIS) is a rare and dangerous result of second concussion that happens when the brain is still healing from a previous concussion. An athlete who is recovering from a concussion, but who has not yet fully recovered, is at risk for second impact syndrome. Typically, the athlete suffers post-concussion symptoms after the first head injury, see above for symptoms. Before these symptoms have cleared, which last usually days or weeks, the athlete returns to competition and receives a second blow to the head. Second-impact syndrome causes dangerous brain swelling and bleeding. Since the brain is contained in the rigid bone of the skull, this swelling causes compression of the brain. In severe cases, the brain is squeezed through small holes within the skull. This squeezing of the brain through these small holes is known as "herniation." Herniation can lead to decreased blood flow to the brain, and ultimately, to permanent disability or death. Second Impact Syndrome be preventable by removing concussed athletes from practice or play until their symptoms have gone away and the athlete is by a health-care professional or the ImPACT program (Barton, 2013) (Sport Concussion, 2013).




Serious Concussion Example








References