1 / 6

Post-Concussion Syndrome

Post-Concussion Syndrome. DSM-IV requires 3 or more symptoms to be present at least 3 months after injury: Anxiety, apathy, depression, dizziness, fatigue, HA, irritability, personality changes, sleep problems ICD-10 dx involves symptoms in 3 or more categories

brede
Download Presentation

Post-Concussion Syndrome

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Post-Concussion Syndrome • DSM-IV requires 3 or more symptoms to be present at least 3 months after injury: • Anxiety, apathy, depression, dizziness, fatigue, HA, irritability, personality changes, sleep problems • ICD-10 dx involves symptoms in 3 or more categories • Role of anxiety and/or beliefs about injury • Educating the patient about possible symptoms and recovery may decrease risk of PCS

  2. Second Impact Syndrome • Brain swelling resulting from >1 mTBI. • Increased ICP, diffuse swelling, brain herniation. • Second injury may result from a less severe impact. • Often fatal – if not fatal, prognosis may be similar to that of severe TBI. • Other sxs: dilated pupils, LOC, loss of eye mvmt, respiratory failure. • Pediatric and adolescent athletes at greater risk for SIS.

  3. Pediatric Athletes • Age-dependent effects since brain is still developing • Status of sutures, skull development, water content and blood volume of brain, and myelination level • Young brain may not recover as well as older brain – but, may require larger force to become injured • Neck/shoulder musculature – less able to transfer forces • Force of impacts – may be lower • Neurobiological Development • Environmental Considerations – school/learning, social network • Consider more conservative approach

  4. Gender Differences • Differences in LOC with concussion • Broshek et al (2005) found gender differences at follow-up after concussion: • Cognitive changes from baseline performance • Self-reported number of symptoms • Differences still existed after adjusting for helmet use • Hormonal differences may contribute • Neuroprotective or negative effects of estrogen controversial – conflicting evidence in rat models • Other differences: • Blood flow rates, rate of glucose metabolism, neuronal density

  5. Conclusions • LOC should not be used to determine severity of injury • Consider impact of injury on various levels: • Somatic, emotional/behavior, & cognitive • Subjective & objective • Tracking/reassessing sxs over time important • Education important • Sxs of concussion • Recovery/return to sport after concussion • Prevention

  6. References Broshek, DK, Kaushik, T, Freeman, JR, Erlanger, D, Webbe, F, & Barth, JT. “Sex differences in outcome following sports-related concussion.” Journal of Neurosurgery; 2005. 102:856-863. DeLaney, J. “The impact of sports: concussion may affect genders differently.” Today in PT; November 2008:18-20. Garvey, D. “Brief clinical update: when can teens return to sports after a head injury?” UCLA Department of Medicine: 2000. Accessed online February 6, 2009 at http://www.med.ucla.edu/modules/wfsection/article.php?articleid=167 Kirkwood, MW, Yeates, KO, & Wilson, PE. “Pediatric sport-related concussion: a review of the clinical management of an oft-neglected population.” Pediatrics; 2006. 117:1359-1371. “Postconcussion syndrome: why this diagnosis is controversial and what treatments may help.” Harvard Mental Health Letter; 2007. 24(6): 6. Mittenberg, W, Canyock, EM, Condit, D, & Patton, C. “Treatment of post-concussion syndrome following mild head injury.” Journal of Clinical and Experimental Neuropsychology; 2001. 23(6): 829-836. Wood, RL. “Post concussialsyndrom: all in the minds eye!” Journal of Neurology, Neurosurgery, and Psychiatry; 2007. 78(6):552.

More Related