Head Injuries

Objectives

Know the difference between concussion, countercoup concussion, & second impact syndrome

Differentiate the grades of concussions based upon their symptoms

Recognize postconcussion/secondary problems

Brain Injuries Closed head injuries = common

Medical, neurological & psychological consequences some serious

Brain = one of the most vascular organs in the body Constant blood and oxygen is needed

Result from direct & indirect trauma

Brain Injuries “Concussion” = agitation or a

shaking of the brain from being hit Countercoup concussion

Brain moves in the fluid surrounding it and is contused by the opposite side of the skull

On-the-Field evaluation & emergency care

Represents a potentially life-threatening situation

If unconscious, a neck injury is always assumed

Evaluate before moving Refer to physician

Mild concussion initially can progress to serious condition

Further evaluation Testing eye signs

Equal pupils Vision – blurred,

double, sensitive to light

Reaction to light Tracking

Balance Recall – short and

long term 100-7 months of the year 5 words number sequencing orientation to

person/place/time

Concussion Grading Scale Grade 1 – Mild

Most common Minimal symptoms Dazed, disoriented, no amnesia “bell rung” Returns to normal status in 10-15

minutes

Concussion Grading Scale Grade 2 – moderate

Unconsciousness lasting less than 5 minutes

Confusion Posttraumatic amnesia – inability to recall

events since an injury Unsteady, nausea, tinnitus, dizzy,

headache Evaluated by a physician

Concussion Grading Scale Grade 3 – Severe

Unconscious for at least 5 minutes Transport to a hospital on a

spineboard Rule out spinal & skull fractures,

internal bleeding

Second Impact Syndrome Occurs when as athlete receives a

2nd concussion before an initial concussion has full resolved

Brain rapidly swells causing a herniation of brain tissue

Potential for death within 15 seconds – 1 minute

Postconcussion Problems Numerous complaints

Impaired memory, lack of concentration, tension, irritability, lightheadedness, fatigue, depression, visual problems

Requires referral

Secondary conditions Brain swelling (cerebral edema)

Localized swelling at the injury site Occurs usually within 12 hours & may

last up to 2 weeks Not related to the intensity of the

trauma Post injury epilepsy & seizures

Can occur immediately Higher incidence when the brain is

contused or with internal bleeding

Secondary conditions Posttraumatic headaches

Mild to severe Following a single incident of repeat

trauma Stem from physical effort Often accompanied by nausea &

vomiting

Return to Play Free of symptoms Determined by a physician

Real life consequences http://msn.foxsports.com/nhl/story/georg

e-parros-montreal-canadiens-slams-face-ice-stretcher-hospitalized-colton-orr-toronto-maple-leafs-100113

http://www.youtube.com/watch?v=f0xJT53SZqQ&feature=related

http://www.youtube.com/watch?v=jH867uCahEE