Warm Up • In your opinion what is the most difficult injury to overcome in sports today? Why? TPO • We will analyze the causes of concussions and the trauma that can be caused from a concussion using notes and discussion • Vocabulary: encephalon, concussion, retrograde, anterograde Central Nervous System Central Nervous System (CNS) • Brain (encephalon) and spinal cord compose the CNS. • CNS is protected by meninges, cranium, and vertebrae. • CNS consists of gray and white matter and weighs 3 to 3.5 lbs (adult). • Brain has three basic components – cerebrum, cerebellum, and brain stem. • Neural impulses travel to and from the CNS via 12 pairs of cranial nerves and 31 pairs of spinal nerves. Head Injuries in Sports Even minor head trauma can result in serious injury. • Brain tissue is unable to repair itself. • Any tissue loss results in some level of permanent disability. • Severe injuries can result in death. • Significant advances in understanding of head injuries ▫ Coaches can learn to recognize head injuries and render first aid when necessary. Head Injuries • Can occur in any sport at any level • Research over who is most susceptible to head injuries is ongoing ▫ Guskiewicz: 3 year study of head/ brain injuries in high school and college football Approximately 300,000 traumatic head or brain injuries Players with a head or brain injury had a 3x higher risk of a second head injury Head Injuries • Cheerleading highest risk of head injury in female sports ▫ Most injuries resulting in catastrophic injury • Injury rates dramatically increasing in soccer and basketball Mechanisms of Head Injury Direct mechanism of injury involves a blow to the head that causes injury at impact site (coup injury) or on the opposite side of the skull from impact (contracoup injury). ▫ Contrecoup: associated injury occurs when the head is moving and stops abruptly ▫ Example: when a tackle is made; brain is moving in the skull then compressed on the side of the head opposite the impact Mechanism of Injury • Indirect injury to the head results from damaging forces traveling from other parts of the body. ▫ blows to the jaw or face ▫ Rapid and violent movement of the cervical spine (whiplash) Treat every head injury as if there is a neck injury and vice versa. Concussions A concussion is “a clinical syndrome characterized by immediate and transient impairment of neurologic function secondary to mechanical forces.” ▫ Symptoms include unconsciousness, disorientation, headache, amnesia (anterograde or retrograde), dizziness, and disequilibrium. Concussions • There is some level of structural damage • Brain cells not destroyed remain extremely vulnerable to another trauma BRAIN TISSUE DOES NOT REPAIR ITSELF!!!!!! Concussion Classification • Variety of systems used • Based on duration of unconsciousness and the pressence or absence of post-traumatic amnesia (PTA) ▫ Retrograde: unable to recall events prior to the injury ▫ Anterograde: unable to recall events after the injury Concussions Classification Cantu classification • Grade 1 (mild) involves no amnesia but are difficult to identify. • Grade 2 (moderate) involves loss of consciousness for less than 1 minute and/or PTA lasting longer than 30 minutes. • Grade 3 (severe) involves loss of consciousness for more than a minute and PTA lasting more than 24 hours. Grade 1 Concussion • Most common • Most difficult to identify • Major distinction between Grade 1 and 2 (Cantu) is loss of consciousness and/or PTA lasting longer than 30 minutes Grade 2 and 3 • Usually have loss of consciousness • Slow response to simple questions • Distinction is amount of PTA Second Impact Syndrome Second Impact Syndrome (SIS) can be a serious problem. ▫ Results when an athlete with a head injury receives another head injury before the symptoms of the initial injury have resolved. ▫ Involves rapid, catastrophic brain swelling. ▫ SIS can result in death. Any athlete sustaining a head injury, no matter how minor, should be referred to a physician before being cleared to return to participation.
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