Concussions:Mild Head Injury… or

Not???

Concussions:Mild Head Injury… or

Not???

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What is a Concussion?What is a Concussion?

• An injury to the brain that may be caused by a blow to the head, face, neck, or elsewhere on the body with an ‘impulsive’ force transmitted to the head.

• All brain injuries can have serious effects on health and well-being, even mild injuries.

• An injury to the brain that may be caused by a blow to the head, face, neck, or elsewhere on the body with an ‘impulsive’ force transmitted to the head.

• All brain injuries can have serious effects on health and well-being, even mild injuries.

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HistoryHistory• All head injuries are serious, even those that

seem minor• Loss of consciousness not required to have

sustained a concussion, in fact most concussions do not involve a loss of consciousness at all

• Recognition and proper treatment can prevent further injury and even death

• Athletes often do not report symptoms for fear of losing playing time. This can result in long term emotional or physical complications, maybe even death

• All head injuries are serious, even those that seem minor

• Loss of consciousness not required to have sustained a concussion, in fact most concussions do not involve a loss of consciousness at all

• Recognition and proper treatment can prevent further injury and even death

• Athletes often do not report symptoms for fear of losing playing time. This can result in long term emotional or physical complications, maybe even death

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SymptomsSymptoms

• There are many symptoms of a concussion

• To be diagnosed a person only needs to have one of the following symptoms

• There are many symptoms of a concussion

• To be diagnosed a person only needs to have one of the following symptoms

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Cognitive SymptomsCognitive Symptoms

• Appear Dazed or Stunned• Confusion• Forgets Plays• Unsure of game, score or opponent• Answers questions slowly• Loses Consciousness• Shows behavior or personality

changes• Can’t recall events before or after

injury• Concentration or memory problems

• Appear Dazed or Stunned• Confusion• Forgets Plays• Unsure of game, score or opponent• Answers questions slowly• Loses Consciousness• Shows behavior or personality

changes• Can’t recall events before or after

injury• Concentration or memory problems

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Physical SymptomsPhysical Symptoms

• Headache or ‘Pressure’ in head• Nausea or Vomiting• Balance problems or dizziness• Clumsy• Double or Blurry Vision• Sensitivity to light or noise• Feeling sluggish, hazy, foggy or

groggy• Does not feel right• Ringing in ears

• Headache or ‘Pressure’ in head• Nausea or Vomiting• Balance problems or dizziness• Clumsy• Double or Blurry Vision• Sensitivity to light or noise• Feeling sluggish, hazy, foggy or

groggy• Does not feel right• Ringing in ears

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CauseCause

Concussions can be caused by: Direct Contact Acceleration/Deceleration forces

that cause a shaking of the brain Rotational forces that cause a

shaking of the brain Does not have to be direct contact

to the head to be a concussion

Concussions can be caused by: Direct Contact Acceleration/Deceleration forces

that cause a shaking of the brain Rotational forces that cause a

shaking of the brain Does not have to be direct contact

to the head to be a concussion

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Diagnositic TestsDiagnositic Tests

• Neurological Exam• Eye Function• Balance Tests• Coordination Tests• Cognitive Tests

• Neurological Exam• Eye Function• Balance Tests• Coordination Tests• Cognitive Tests

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RisksRisks

• After first concussion, your risk of getting another concussion is 3-6 times greater

• If you get another concussion before the first one has healed you can get what is called Second Impact Syndrome and risk death

• Concussions can lead to long term disturbances in health and well-being

• After first concussion, your risk of getting another concussion is 3-6 times greater

• If you get another concussion before the first one has healed you can get what is called Second Impact Syndrome and risk death

• Concussions can lead to long term disturbances in health and well-being

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PreventingPreventing• Proper fitting helmet or headgear

reduce injury• Correct technique in contact sports can

reduce injury• No protective device will completely

eliminate risk for injury• You can still suffer a concussion even

with the best helmets or head gear on the market

• Proper fitting helmet or headgear reduce injury

• Correct technique in contact sports can reduce injury

• No protective device will completely eliminate risk for injury

• You can still suffer a concussion even with the best helmets or head gear on the market

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TreatmentTreatment

• REST!• To heal properly the brain needs physical

and mental rest• Athlete must be symptom free for at least 1

week and evaluated and cleared by medical health professional before returning to activity.

• Symptoms should resolve in 7-10 days unless they’ve had multiple concussions, or if it was more severe, then they can last weeks to months

• REST!• To heal properly the brain needs physical

and mental rest• Athlete must be symptom free for at least 1

week and evaluated and cleared by medical health professional before returning to activity.

• Symptoms should resolve in 7-10 days unless they’ve had multiple concussions, or if it was more severe, then they can last weeks to months

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Return to play guidelinesReturn to play guidelines

• An athlete who has any loss of consciousness must be immediately removed from competition and sent to a Physician for further evaluation

• All symptoms should be completely gone for a minimum of:– 1 week for the 1st concussion– 2 weeks for the 2nd– until a Physician’s clearance for the 3rd concussion

• All concussions, mild or severe, must be cleared by a medical health professional before returning to play!

• An athlete who has any loss of consciousness must be immediately removed from competition and sent to a Physician for further evaluation

• All symptoms should be completely gone for a minimum of:– 1 week for the 1st concussion– 2 weeks for the 2nd– until a Physician’s clearance for the 3rd concussion

• All concussions, mild or severe, must be cleared by a medical health professional before returning to play!

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MythsMyths• “After 1 concussion you will lose intelligence”

– Multiple concussions can cause emotional and physical disturbances but if recognized and treated properly the chance of long term effects are lower

• “A second concussion can make you remember things that you had forgotten after the first concussion”– If you have suffered amnesia following a concussion

it can sometimes come back with rest, but cannot be knocked back into you

• “Being knocked unconscious always causes permanent brain damage”– Some damage can heal with proper rest and

treatment, but improper treatment can result in permanent brain damage

• “After 1 concussion you will lose intelligence”– Multiple concussions can cause emotional and

physical disturbances but if recognized and treated properly the chance of long term effects are lower

• “A second concussion can make you remember things that you had forgotten after the first concussion”– If you have suffered amnesia following a concussion

it can sometimes come back with rest, but cannot be knocked back into you

• “Being knocked unconscious always causes permanent brain damage”– Some damage can heal with proper rest and

treatment, but improper treatment can result in permanent brain damage

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Other InformationOther Information

• A coma (or extended loss of consciousness) should be treated respectively

• Any concussion can lead to emotional disruptions

• If an athlete has trouble remembering who they are, or who people are around them it is likely they will exhibit other more serious symptoms as well

• A coma (or extended loss of consciousness) should be treated respectively

• Any concussion can lead to emotional disruptions

• If an athlete has trouble remembering who they are, or who people are around them it is likely they will exhibit other more serious symptoms as well

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The following slides show different head injuriesrelated to concussions that are important to know about

as well.

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Post-Concussion SyndromePost-Concussion Syndrome

Persistent headache or any other concussion symptoms that persist weeks after concussion

Persistent headache or any other concussion symptoms that persist weeks after concussion

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Second Impact SyndromeSecond Impact Syndrome

• Rapid swelling of brain from second injury to head before previous head injury resolved

• May be caused by any blow to head, even very minor ones

• Life Threatening Emergency

• Rapid swelling of brain from second injury to head before previous head injury resolved

• May be caused by any blow to head, even very minor ones

• Life Threatening Emergency

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Symptoms and TreatmentSymptoms and Treatment

• Symptoms:– Look stunned, within seconds to

minutes condition rapidly worsens, dilated pupils, coma, respiratory failure, loss of eye movement

• Treatment:– Best treatment is prevention through

management of concussions, Emergency care, very high death rate

• Symptoms:– Look stunned, within seconds to

minutes condition rapidly worsens, dilated pupils, coma, respiratory failure, loss of eye movement

• Treatment:– Best treatment is prevention through

management of concussions, Emergency care, very high death rate

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Epidural HematomaEpidural Hematoma

• Blow to head often with skull fracture tearing meningeal arteries

• Blood accumulation between dura mater and skull

• Requires surgery

• Blow to head often with skull fracture tearing meningeal arteries

• Blood accumulation between dura mater and skull

• Requires surgery

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Subdural HematomaSubdural Hematoma

• Result of acceleration/deceleration forces that cause bleeding between dura and brain

• Symptoms:– Unconscious, dilation of one pupil,

headache, dizziness, nausea or sleepiness

• Life threatening-911!

• Result of acceleration/deceleration forces that cause bleeding between dura and brain

• Symptoms:– Unconscious, dilation of one pupil,

headache, dizziness, nausea or sleepiness

• Life threatening-911!