Mild traumatic brain injury: Difference between revisions

Revision as of 22:53, 26 June 2011

Background

Simple concussion
- Gradual resolution of symptoms w/in 7-10d
Complex concussion
- Persisting symptoms or cognitive impairment
- Symptoms with exertion

Treatment

Simple
- Limitations on playing and training while symptomatic
- F/u with PMD
Complex
- Refer to sports medicine or concussion specialist

Authors:

@@ Line 1: / Line 1: @@
-CONCUSSIONS
+==Background==
--    transient aloc p trauma with neg ct
+*Simple concussion
+**Gradual resolution of symptoms w/in 7-10d
+*Complex concussion
+**Persisting symptoms or cognitive impairment
+**Symptoms with exertion
--    but neg ct does not r/o diffuse axonal inj or microscopic inj
+==Treatment==
+*Simple
--    with concussion can have abnormal neuro fnc for few days
+**Limitations on playing and training while symptomatic
+**F/u with PMD
--    second impact syndrome- irrev brain damage p prior concussion after minor head inj- due to disordered autoregulation
+*Complex
+**Refer to sports medicine or concussion specialist
--    ct not as good as mri but good enough to find lesions requiring medical/ surgical eval
--    risk of subsequent deterioration p neg initial ct is very low
--    isolated skull fx and neg ct- few complications
--    post traumatic sz with neg ct and neg neuro exam- low risk for subsequent sz
--    theoretical risk for delayed bleeding p initial neg ct but these pts usually have abnormal neuro on presentation
--    is normal neuro and neg ct, chance of delayed bleeding very rare
--    minor trauma can give long term neuropsych changes- cognitive fnc, problem solving, attention, concentration- usually resolve p 1 yr
--    the more concussions, the poorer the score on neuropsych testing
-==Return to Sports==
-minor- consussion, no LOC, neuro change <15 min- 1 wk no sports
-Grade 2- consussion, no loc, neuro change >15 min- 1- 2 wks no sports
-Grade 3- concussion w LOC- no sports for 2 wks
-if second grade 3, no sport for 1 mo and ct pos- no sports for rest of season and possible for ever!
 [[Category:Peds]]
 [[Category:Trauma]]
 [[Category:Neuro]]