Biology 12

Concussions, Strokes & Brain Related Injuries

Concussionshttp://www.freemd.com/concussion/

• What is a concussion?• A concussion is a type of brain injury that causes a temporary

disturbance in brain function. Most concussions are the result of a direct blow to the head with a blunt object. These injuries range from mild to severe. Not all concussions cause a loss of consciousness, but loss of consciousness and amnesia are two of the most commonly seen features of concussion. Concussions represent about 8.9% of all high school athletic injuries.

• What are the symptoms?• A concussion can cause headaches, loss of consciousness,

loss of memory, confusion, changes in mood, slurred speech, sleep difficulties, nausea, vomiting, and sensitivity to light and loud noises.

• Evaluation• Blood behind the eardrum:

• May be a sign of basilar skull fracture• Bruising behind the ear or around both eyes:

• May be a sign of basilar skull fracture • Clear fluid leaking from the nose:

• A sign of basilar skull fracture• Large scalp contusion• Neck tenderness • Skull deformity:

• A depressed area on the skull• Visible skull fracture through a scalp wound

Concussionshttp://www.freemd.com/concussion/

• Testing• Skull x-rays • CT scan of the brain • MRI scan of the brain • X-rays of the neck:

• Normal cervical spine • Torn ligaments • Fracture of the odontoid process of the second vertebra • Fracture of a vertebral body • Fracture of a spinous process in the back of a neck vertebra

Concussionshttp://www.freemd.com/concussion/

• Treatment• Treatment for a concussion includes rest and close observation. It

is very important that a person with a concussion does not return to sports activities, or situations in which further head injury may occur, until symptoms resolve. In addition, a person who has lost consciousness at the time of the injury must rest, even if symptoms have resolved.

In addition to physical rest, those with concussions require cognitive rest, which involves resting the brain. The person should avoid challenging mental tasks until symptoms resolve. Treatment may also include acetaminophen or nonsteroidal anti-inflammatory medications for pain.

Concussionshttp://www.freemd.com/concussion/

• Treatment Cont’d• Avoid alcohol.• Avoid narcotic pain medications. • Avoid medications that make you sleepy.• Avoid driving until symptoms resolve.• Apply cold compresses to the scalp:

• Wrap ice in a moist hand towel. Do not apply ice directly to the skin.• Apply for 20-30 minutes, every 1-2 hours, for the first few days.

• Clean wounds thoroughly:• Use mild soap and water.• Gently dab the wound with hydrogen peroxide to remove clotted blood.• Do not scrub the wound.• Remove dirt or foreign material from the wound.• Dry the skin.• Apply an antibiotic ointment.

• Eat a clear liquid diet for 24 hours.• Rest for 1-2 days. There is no need to try and keep the victim awake.• Perform neurological checks:

• Every 1-2 hours for 24 hours• Make sure the person can be awakened• Make sure the person can walk• Make sure the person can speak normally• Make sure the person can move extremities normally

• Acetaminophen for pain • Avoid aspirin.

Concussionshttp://www.freemd.com/concussion/

Concussionshttp://www.freemd.com/concussion/

• Grade 1 concussion:• Defined by:• Transient confusion• No loss of consciousness• Mental status changes last for less than 15 minutes

• Recommendations:• Return to sports activity same day only if all symptoms

resolve within 15 minutes• If a second grade 1 concussion occurs, no sports activity

for 1 week

Concussionshttp://www.freemd.com/concussion/

• Grade 2 concussion:• Defined by:• Transient confusion• No loss of consciousness• Mental status changes last for 15 minutes or more

• Recommendations:• No sports activity for 1 week• If a grade 2 concussion occurs on the same day as a

grade 1, no sports activity for 2 weeks

Concussionshttp://www.freemd.com/concussion/

• Grade 3 concussion:• Defined by:• Loss of consciousness

• Recommendations:• No sports activity for 1 week if loss of consciousness was only

seconds• No sports activity for 2 weeks if loss of consciousness was

minutes or longer• If a second grade 3 concussion, no sports activity until the

person has no symptoms for 1 month• If abnormality is seen on CT scan of the brain or MRI scan or the

brain, no sports activity for the rest of the season and the athlete should be discouraged from returning to contact sports.

Concussion Videos

• http://www.macleans.ca/society/health/the-aftershocks/• https://vimeo.com/6089854

Strokeshttp://www.strokeassociation.org/STROKEORG/AboutStroke/About-Stroke_UCM_308529_SubHomePage.jsp

• What is a stroke?• A stroke is a disease that affects the arteries leading to

and within the brain. • A stroke occurs when a blood vessel that carries oxygen

and nutrients to the brain either bursts, ruptures or is blocked by a clot. As a result, the brain cannot get the blood and oxygen it needs and pieces of the brain die.

Strokeshttp://www.strokeassociation.org/STROKEORG/AboutStroke/About-Stroke_UCM_308529_SubHomePage.jsp

• Stroke risk factors• Approximately 80 percent of strokes can be prevented.

Though some stroke risk factors are uncontrollable, such as age and race, other risk factors are in your control and making small lifestyle changes can reduce your stroke risk.

• Seven main risk factors: Be active, control cholesterol, eat a healthy diet, manage blood pressure, maintain a healthy weight, control blood sugar and don’t smoke.

Strokes - Typeshttp://www.strokeassociation.org/STROKEORG/AboutStroke/About-Stroke_UCM_308529_SubHomePage.jsp

• An ischemic stroke occurs when a clot or mass clogs a blood vessel cutting off the blood flow to brain cells. • 87% of all strokes

are ischemic.

Strokes - Typeshttp://www.strokeassociation.org/STROKEORG/AboutStroke/About-Stroke_UCM_308529_SubHomePage.jsp

• A hemorrhagic stroke results from a weakened vessel that ruptures and bleeds into the surrounding brain tissue.

• The blood accumulates and forms a bruise within the brain tissue, compressing brain cells and causing them to die.

Strokes - Typeshttp://www.strokeassociation.org/STROKEORG/AboutStroke/About-Stroke_UCM_308529_SubHomePage.jsp

• A TIA, or Transient Ischemic Attack, produces stroke like symptoms.

• A TIA is caused by a clot; but unlike a stroke, the blockage is temporarty and usually causes no permanent damage to the brain.

• Often called “mini strokes”

• Approximately 15% of all strokes occur after a TIA.

Strokeshttp://www.strokeassociation.org/STROKEORG/AboutStroke/About-Stroke_UCM_308529_SubHomePage.jsp

• Identifying a stroke – F.A.S.T• F – Face dropping. Does one side of the face droop or is it

numb? Ask the person to smile.• A – Arm weakness. Is one arm weak or numb? Ask the

person to raise both arms. Does one arm drift downward?• S – Speech difficulty. Is speech slurred, are they unable to

speak, or are they hard to understand? Ask the person to complete a sentence, like “is the sky blue.” Is it repeated correctly?

• T – Time to call 911. Immediately if a person has these symptoms, even if they go away.

Stroke Videos

• https://www.youtube.com/watch?v=pcmrgwNCPwM• https://www.youtube.com/watch?v=uLJewzJcCZ0• https://www.ted.com/talks/

jill_bolte_taylor_s_powerful_stroke_of_insight?language=en

Phineas Gage

• https://www.youtube.com/watch?v=FrULrWRlGBA• Please read the section on Phineas Gage in your

textbook, starting on page 432, and answer questions 1 & 2.

Disorders – Lobes of the Brain

• https://www.youtube.com/watch?v=2MKNsI5CWoU• http://www.brainline.org/multimedia/

interactive_brain/the_human_brain.html?gclid=CL2w-K2uzrICFYVFMgod-EcACw• Use this website to create a table of the lobes of the

brain, and what could be affected if that lobe was injured.