Diagnostics
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What Is Concussion? What Is Mild Traumatic Brain Injury (MTBI)?
Concussion is also known as mild brain injury, mild traumatic brain injury (MTBI), mild head injury and minor head trauma. Some experts define concussion as a head injury with temporary loss of brain function, which can cause cognitive, physical and emotional symptoms. Concussion may also be defined as an injury to the brain generally caused by a jolt or blow to the head - in the majority of cases the individual does not lose consciousness. According to Medilexicon"s medical dictionary, concussion is "An injury of a soft structure, as the brain, resulting from a blow or violent shaking." In sports medicine the term concussion is commonly used, while in general medicine MTBI (mild traumatic brain injury) may be used as well. Lay people are more familiar with the term concussion. According to the Brain Injury Association of America males are twice as likely as females to sustain a brain injury. Those at highest risk of a brain injury are males aged 15 to 24 years. People who have had a brain injury are more likely to experience a subsequent brain injury. In 2008 there were 351,992 sports-related head injuries that were treated in hospital emergency rooms in the USA, according to the U.S. Consumer Product Safety Commission. Neurology / Neuroscience News For the latest news and research on Neurology / Neuroscience, and to sign up to newsletters or news alerts, please visit our: Neurology / Neuroscience News Section Researchers from the Centre de recherche en neuropsychologie et cognition, Universitçİ de Montrçİal, Canada found evidence that athletes who were concussed during their earlier sporting life show a decline in their mental and physical processes more than 30 years later. What are the causes of concussion? The brain floats in cerebral fluid which protects it from jolts and bumps. A violent jolt or a severe blow to the head can cause the brain to bump hard against the skull. This can result in the tearing of fiber nerves as well as blood vessel rupture under the skull, leading to an accumulation of blood. *Automobile accidents - concussions commonly occur from severe jolts to the head; this can happen when a vehicle suddenly loses speed or stops dead, causing the brain to jar (bash, bump hard) against the skull. *Sports injuries - especially contact sports, such as martial arts, boxing, rugby, American football, and hokey. Non-contact sports such as snowboarding and skiing as well. *Falls - any fall that results in a blow to the head or a severe jolt. The majority of concussion cases in very young children and elderly individuals in the USA and UK occur as a result of a fall in the home. *Horseback riding accidents - there were 11,749 cases of head injuries resulting from horseback riding accidents in 2008 in the USA, according to the U.S. Consumer Product Safety Commission. *Playground accidents - especially in playgrounds that do not have proper soft underlays. *Cycling accidents - according to the U.S. Consumer Product Safety Commission there were 70,802 cases of head injuries that resulted from cycling accidents. *Assaults - 11% of traumatic brain injuries in the USA are caused by assaults (people being attacked), according to the CDC (Centers for Disease Control and Prevention). Different grades of concussion Concussion is usually classified into 3 different grades. Below are three of the most widely used ways of classifying concussion: *Cantu guidelines (Devised by Dr. Robert Cantu, medical director of the National Center for Catastrophic Sports Injury Research) Grade 1 - Some amnesia lasting no longer than 30 minutes, no loss of consciousness. Grade 2 - Loss of consciousness lasting no longer than 5 minutes. Amnesia lasting from 30 minutes to 24 hours. Grade 3 - Loss of consciousness lasting more than 5 minutes. Amnesia lasting more than 24 hours. *Colorado Medical Society guidelines: Grade 1 - Confusion. No loss of consciousness. Grade 2 - Confusion. Amnesia. No loss of consciousness. Grade 3 - Any loss of consciousness. *American Academy of Neurology guidelines: Grade 1 - Confusion that lasts less than 15 minutes. No loss of consciousness. Grade 2 - Confusion last lasts for more than 15 minutes. No loss of consciousness. Grade 3 - Loss of consciousness (IIIa coma lasts seconds, IIIb coma lasts for minutes) What are the signs and symptoms of concussion? Signs and symptoms of concussion may not be noticeable straight away. (A sign is what a doctor can see, hear or feel, such as a rash, or slurred speech. A symptom is something the patient describes, such as a headache, or ringing in the ears.) Sports Medicine News For the latest news and research on Sports Medicine, and to sign up to newsletters or news alerts, please visit our: Sports Medicine News Section Immediate signs and symptoms may include: *Loss of consciousness. *Confusion. *Headache. *Slurred speech. *Dizziness. *Ringing in the ears. *Nausea. *Vomiting. *Amnesia. *Tiredness (fatigue). The following signs and symptoms may not be noticeable for several hours, or even days: *Amnesia. *Depression. *Disturbed sleep. *Hyperacusis - sensitivity to sounds. *Irritability. *Lack of concentration, focus. *Moodiness. *Photophobia - sensitivity to light. The following signs and symptoms may be linked to a more serious injury and medical help should be sought: *Prolonged headache. *Prolonged dizziness. *Dilated pupils. *The two pupils are not the same size. *Prolonged nausea and vomiting. *Memory loss does not improve. *Ringing in the ears. *Loss of sense of smell. *Loss of sense of taste. Concussion signs and symptoms in children - this may be more difficult to detect in very young children because they may not yet have the ability to adequately explain how they feel or identify what needs to be reported. Signs may include: *Lethargy, listlessness. *Irritability - the child gets cross easily. *Changing sleeping patterns. *Altered appetite. *Walking and/or standing unsteadily (any signs of balance, dizziness problems). Children - the following signs usually mean the child needs medical attention: *The child loses consciousness. *After attempting to stem the bleeding, a cut continues to bleed. *Any change in the way the child walks. *Bleeding from the ears. *Bleeding from the nose. *Blurred vision. *Confusion - the child does not know where he/she is, may not recognize familiar people. *Continuous crying. *Convulsion (seizure). *Discharge from the ears. *Discharge from the nose. *Dizziness. *Loss of appetite. *Prolonged headache. *Prolonged irritability. *Prolonged listlessness, fatigue, lethargy. *Repeated or forceful vomiting. *Speech is slurred. *Worsening headache. How is concussion diagnosed? Some s say that most people can diagnose concussion if the symptoms are present immediately. If an individual has experienced a severe jolt or blow to the head which has left them dazed, confused, or wobbly they have concussion. However, a Canadian study revealed that most minor league hokey players are unable to identify a concussion or its related symptoms . Dr. Cusimano, a professor of neurosurgery, education and public health at the University of Toronto said "Serious misconceptions exist among minor league hockey players, athletes, coaches and parents when it comes to understanding the signs and symptoms of a concussion and its treatment." Determining the severity of the concussion is more difficult because the signs and symptoms may not become evident until later. Mark R. Lovell, Ph.D., director of the University of Pittsburgh Medical Center (UPMC) Sports Medicine Concussion program, said that athletes may have severe concussion without becoming unconscious. In a report published in The American Journal of Sports Medicine Lovell explained that amnesia and confusion on the field after injury may be as important, if not more important, in making a return-to-play decision. A GP (general practitioner, primary care physician) or hospital doctor will ask the patient details about the trauma (the blow to the head, the accident). It may be necessary to question the people who accompanied the patient. A neurological examination will also be done, which will include evaluating the patient"s: *Balance *Concentration *Coordination *Hearing *Memory *Reflexes *Vision If the patient is over 65 years old, fell from a height of over 3 feet, was involved in a vehicle accident, has been consuming alcohol or drugs, cannot remember what happened 30 minutes or longer after the incident, has short-term memory problems, has been vomiting, had a seizure, has bruising or cuts and scrapes on the head and/or neck, or appears to have a fractured skull, the doctor may order a CT scan. Glasgow Coma Scale Doctors often use the Glasgow Coma Scale (GCS) before deciding whether to use a CT scan. The GCS is a way for doctors and nurses to assess the severity of brain damage following a head injury. It scores patients according to verbal responses, motor responses (physical reflexes), and how easily they can open their eyes. *Eyes - Glasgow Coma Scale Score of 1 - does not open eyes. Score of 2 - opens eyes in response to painful stimuli (when given pain). Score of 3 - opens eyes in response to voice. Score of 4 - opens eyes spontaneously. *Verbal - Glasgow Coma Scale Score of 1 - makes no sound. Score of 2 - incomprehensible sounds (mumbles). Score of 3 - utters inappropriate words. Score of 4 - confused, disorientated. Score of 5 - oriented, chats normally. *Motor (physical reflexes) - Glasgow Coma Scale Score of 1 - makes no movements. Score of 2 - extension to painful stimuli (straightens limb when given pain). Score of 3 - abnormal flexion to painful stimuli (moves in a strange way when given pain). Score of 4 - flexion/withdrawal to painful stimuli (moves away when given pain). Score of 5 - localizes painful stimuli (can pinpoint where pain is). Score of 6 -Pages: [1] 2