It's Super Bowl Time! Football is one of America's favorite pastimes but it comes with more than it's fair share of injuries. Due to the nature of the game concussions are always a very real possibility.
According to study results published in the Clinical Journal of Sports Medicine the definition of a concussions is"a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. Several common features that incorporate clinical, pathological, and biomechanical injury constructs that may be used in defining the nature of a concussive head injury.
Concussion may be caused by a direct blow to the head, face, neck, or elsewhere on the body with an "impulsive" force transmitted to the head."
-simple reaction time task: the subject has to press the response key as fast as possible when the central face down card turns face up
-complex reaction time task: two cards turn face up at the same time and the subject has to press one of two response keys as fast as possible, depending on whether the cards are the same or different in colour
-monitoring task: five cards jiggle randomly up and down between two parallel white lines, the subject has to press the response key as fast as possible when any card touches the white line
-one back task: the subject has to press one of two response keys as fast as possible, depending on whether the new card is the same or different from the last card presented
-matching task: six target face up card pairs are shown on top of the screen and the subject has to decide whether the new face up card pair matches one of those six target pairs
-incidental learning task: part way through the matching task, the six target pairs turn face down and the subject has to perform the matching task base on the memory of the target pairs
-learning task: similar to the matching task, except each of the target pair turns face down after the first presentation of a matching pair to the target pair.
Concussion may be caused by a direct blow to the head, face, neck, or elsewhere on the body with an "impulsive" force transmitted to the head."
The study reveals that many such injuries are never reported. Approximately 1/3 of the concussions found are actually older injuries found while assessing a current trauma.
New guidelines have been put into place to determine if a concussion does exist or at least the need for a medical evaluation of possible injury based on the latest research done by questionnaires, physical assessments and MRI testing. Criteria set forth by American Association of Neurology is in the form of a scoring system called the Post Concussion Symptom Scale. The PCSS scores symptoms on a scale of 0-5 according to severity with 0 being none at all and 6 being most severe. The rating is to be given on only the symptoms being experienced at the time of assessment.
The Results
Low scores: 6-21
Moderate scores: 22-84
Severe: 85-100
Computerized Testing
-simple reaction time task: the subject has to press the response key as fast as possible when the central face down card turns face up
-choice reaction time task: the subject has to press one of two response keys as fast as possible, depending on the colour of the central face down card that turns face up
-complex reaction time task: two cards turn face up at the same time and the subject has to press one of two response keys as fast as possible, depending on whether the cards are the same or different in colour
-monitoring task: five cards jiggle randomly up and down between two parallel white lines, the subject has to press the response key as fast as possible when any card touches the white line
-one back task: the subject has to press one of two response keys as fast as possible, depending on whether the new card is the same or different from the last card presented
-matching task: six target face up card pairs are shown on top of the screen and the subject has to decide whether the new face up card pair matches one of those six target pairs
-incidental learning task: part way through the matching task, the six target pairs turn face down and the subject has to perform the matching task base on the memory of the target pairs
-learning task: similar to the matching task, except each of the target pair turns face down after the first presentation of a matching pair to the target pair.
MRI
MRI imaging was also used to evaluate changes and differences in brain activity related to memory during tasks performed.
Findings
- Those of high school age or younger appear to be a greater risk
- Having the 1st concussion increases risk for subsequent concussions
- helmets do add some level of protection vs no helmet at all
Symptoms
- Headache or head pressure
- Temporary loss of consciousness
- Confusion or a "fuzzy headed" feeling
- Amnesia surrounding injury
- Dizziness
- Ringing in the ears
- Nausea and/or vomiting
- Slurred speech
- Fatigue
Diagnosis
- Neurological Testing (determining cognitive status changes)
- CT Scan (computer tomography) of the head
Complications
- Greater risk for seizures
- Cognitive impairment with multiple traumas
- Second Impact Syndrome-brain swelling that could be fatal if 2nd concussion occurs before 1st trauma symptoms have resolved
Treatment
- REST! physical as well as mental
- Acetaminophen for pain (avoid NSAIDS due to risk of bleeding)
- Avoid sports, vigorous activity or anything that could result in another trauma while symptoms are present
