Mild traumatic brain injury: Difference between revisions
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{{Intracranial hemorrhage DDX}} | {{Intracranial hemorrhage DDX}} | ||
== | ==Diagnosis== | ||
*Based on history and clinical evaluation | |||
==Management== | |||
*Simple | *Simple | ||
**Limitations on playing and training while symptomatic | **Limitations on playing and training while symptomatic | ||
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==Disposition== | ==Disposition== | ||
*Upon discharge from the ER all patients with a diagnosis of concussion should receive educational materials on activities to avoid and symptoms to anticipate during recovery | *Upon discharge from the ER all patients with a diagnosis of concussion should receive educational materials on activities to avoid and symptoms to anticipate during recovery as those who received it have better long-term outcomesials<ref>Ronsford J, et al. Impact of early intervention on outcome after mild traumatic head in adults. 2002</ref> | ||
*Recommend strict rest for 1-2 days with gradual introduction back to regular activity<ref>Thomas DG, Apps JN, Hoffmann RG, et al. Benefits of strict rest after acute concussion: a randomized controlled trial. Pediatrics. 2015; 2(135):213-223.</ref> | |||
==Prognosis== | ==Prognosis== | ||
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==See Also== | ==See Also== | ||
*[[Head Trauma (Main)]] | *[[Head Trauma (Main)]] | ||
*[[Severe traumatic brain injury]] | |||
== | ==References== | ||
<references/> | <references/> | ||
Revision as of 02:05, 12 June 2016
Background
- Concussion (mild TBI) is defined as GCS 14-15 w/ assoc signs or symptoms after a blunt force or acceleration-deceleration injury
- Types
- Simple concussion
- Gradual resolution of symptoms w/in 7-10d
- Complex concussion
- Persisting symptoms or cognitive impairment
- Symptoms with exertion
- Simple concussion
Diagnosis
- Any alteration in the mental state at the time of event or subsequent to the event
- Symptoms may be delayed by days-weeks
- Most consistent abnormality is subtle impairments in cognitive function
- Attention, concentration, memory, processing speed, reaction time
- Physical signs/symptoms
- HA, dizziness, insomnia, fatigue, uneven gait, N/V, blurred vision, seizures
- Behavioral changes
- Irritability, depression, anxiety, sleep disturbances, problems related to school/work
Differential Diagnosis
Intracranial Hemorrhage Types
- Intra-axial
- Hemorrhagic stroke (Spontaneous intracerebral hemorrhage)
- Traumatic intracerebral hemorrhage
- Extra-axial
- Epidural hemorrhage
- Subdural hemorrhage
- Subarachnoid hemorrhage (aneurysmal intracranial hemorrhage)
Diagnosis
- Based on history and clinical evaluation
Management
- Simple
- Limitations on playing and training while symptomatic
- F/u with PMD
- Complex
- Refer to sports medicine or concussion specialist
Disposition
- Upon discharge from the ER all patients with a diagnosis of concussion should receive educational materials on activities to avoid and symptoms to anticipate during recovery as those who received it have better long-term outcomesials[1]
- Recommend strict rest for 1-2 days with gradual introduction back to regular activity[2]
Prognosis
- At 3 mo after injury <30% are symptomatic
- At 1 yr after injury 15% are symptomatic