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Dr. Ajith Kumar J MD
Dept. of Emergency Medicne
Travancore Medicity, Kollam
India
editor
Concussion
Concussion is defined as alteration of consciousness as a result of closed head injury, but is generally used in describing mild head injury without imaging abnormalities.
Key Features : Confusion, amnesia
Patient may be easily distractable, forgetful, slow to interact or emotionally labile.
Gait disturbance and incoordination may be seen.
The mechanics of atypical concussion involve sudden deceleration of the head when hitting a blunt object. This creates an anterior-posterior movement of the brain within the skull due to inertia and rotation of the cerebral hemispheres on the relatively fixed upper brainstem.
LOC in concussion is believed to result from a transient electrophysiological dysfunction of the RAS in the upper midbrain that is at the site of rotation.
Amnesia & Concussion
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Postconcussive syndrome is a loosely defined constellation of symptoms, persisting for a prolonged period after injury, and exacerbated in some patients by the potential for secondary gain.
Characterized by headache, dizziness and disorders of hearing and vision.
They may also suffer a variety of neurocognitive and neuropsychological disturbances, including difficulty with concentration and recall, insominia, emotional lability, fatigue, depression and personality change.
Diffuse Axonal Injury
It is a form of primary brain injury, seen in high energy accidents and which usually renders the patient comatose.
It is a deep white matter lesion consists of widespread mechanical disruption or shearing, of axons at the time of impact.
It is strictly a pathological diagnosis made at post-mortem, but haemorrhagic foci in the corpus callosum and dorsolateral rostral brainstem on CT may be suggestive, although the CT often appears normal.
Concussion in Sports
Risk Factors
Imaging
Return to Play
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Updated on 17/7/2015
Reference :
Bailey & Love. 26 th edition
Harrison's Principle` of Internal Medicine. 18 th edition
Update: Evaluation & Management of Concussion in Sports. AAN.2013
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emmedonline
Dr. Ajith Kumar J MD
Dept. of Emergency Medicne
Travancore Medicity, Kollam
India
editor