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Play It Smart:                            What you need to know                            about sports concussions       ...
Our MissionTo ensure that every person is given opportunities for lifelong learningand fulfillment.We do this by altering ...
3
Why the increased focus onsports-related concussions? Concussions are common in sports, and  their frequency appears to b...
What is a Concussion?A concussion ( or mildtraumatic brain injury) is acomplex physiologicalprocess affecting thebrain, in...
What is a Concussion?Disturbance of brainfunction is related toneurometabolicdysfunction rather thanstructural brain injur...
What is a Concussion?Concussion may or maynot involve a loss ofconsciousness  7
What is a Concussion?Results in a constellationof physical, cognitive,emotional, and sleep-related symptomsSymptoms may la...
Current Diagnosis of Concussion       Does not require LOC       Does not require a direct blow to the head       Does ...
Sports and Concussions In the United States there are  over 3.8 million sports related  concussions a year. It is estima...
Sports and Concussions 34% of college football  players have suffered at least  one concussion. 20% of college football ...
Sports and Concussions All sports and recreation-related concussion in  U.S. 1.6-3.8 million/year Concussion is COMMON i...
Sports and ConcussionsCommonly involve: Other players Falls on hard surfaces Equipment  13
“Limited Contact” Sports AlsoCarry a Risk of Concussion    Baseball              Raquetball    Bicycling             I...
Head Injuries Per Sport 2010 Cycling: 85,389 Football: 46,948 Baseball/softball: 38,394 Basketball: 34,692 Water spor...
Head Injuries Per Sport 2010 Skateboards/scooters:  23,114 Winter sports: 16,948 Horseback riding: 14,466  16
Gender Differences  17
Mechanism of Injury18
Mechanism of Injury19
20
Pathophysiology 21
Metabolic Abnormalities Potassium, glutamate and glucose are  immediately released from affected brain cells Calcium ent...
Neurometabolic Changes and Concussion 23
Injury Aftermath An energy crisis in the brain The brain is vulnerable to further damage  24
Emergency Symptoms    Changes in alertness and consciousness    Seizures    Muscle weakness on one or both sides    Pe...
26
Concussion Symptoms Headache                Feeling slowed down Nausea/Vomiting         Foggy Balance Problems/      ...
Observed Signs of Concussion    Appears dazed, stunned    Confused about assignment/position    Forgets an instruction...
Cumulative Effects Increased severity of  symptoms with  subsequent concussions Unknown effects on  the developing brain...
Second Impact Syndrome Experiencing a second  concussion before signs and  symptoms of a first  concussion have resolved ...
Second Impact Syndrome Athletes should never to  return to sports while  theyre still experiencing  symptoms of concussio...
Post Concussion Syndrome 20-25% of patients who suffer a  concussion residual symptoms Estimated < 5% of sports related ...
Post Concussion SyndromeSymptoms    Headache    Dizziness    Sensitivity to light and sound    Blurred vision    Conc...
Post Concussion Syndrome Most people recover fully  from post concussion  syndrome within 3-6 months. However, 7-15% of ...
Long Term Effects of Concussions  Chronic Clinical Changes seen in NFL players       - Increased risk of cognitive impair...
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Concussion Management  ANY Signs or Symptoms: NO RETURN   TO ANY SPORTS ACTIVITY  Rest  Gradual Return to Play 37
Clinical Dilemma of Concussion  There is no proven treatment-the injury must   run its course  The severity of the concu...
Concussion Management REMOVE                     athlete from play REFER                      to medical provider REST    ...
We Don’t Know……     How many concussions are too many?     When the brain is really back to “normal”?     If pharmocoth...
Prevention  Teach safe techniques in   practice and play  Encourage recognition   and reporting of   concussion symptoms...
Prevention  Use available assessment   tools  Monitor developments   at advanced levels of   play and legislative   effo...
Education 43
44
Videos About ConcussionsCan Be Seen On https://www.nanonline.org/NAN/_Research _Publications/Concussions_in_Sport.aspx  45
Resources  Mayo Clinic http://www.mayoclinic.com  The Center for Sports Concussion at Idaho   State University www.knowc...
Resources Concussion tear-off pad: a resource for coaches, physical education teachers, school nurses, community youth spo...
Thank you!48
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Bancroft sports concussions

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Whether playing football, soccer or just riding a bicycle, everyone is vulnerable to concussions. This webinar will provide the latest medical information on how to identify, treat and prevent sports concussions – and the mild traumatic brain injuries they result in.

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Bancroft sports concussions

  1. 1. Play It Smart: What you need to know about sports concussions Cynthia L. Boyer, Ph.D. Executive Director, Brain Injury Services September 26, 2012@2012 All rights reserved
  2. 2. Our MissionTo ensure that every person is given opportunities for lifelong learningand fulfillment.We do this by altering perceptions, and by supporting those withintellectual and developmental challenges and acquired brain injuries inachieving their life goals as valued and respected members of our world. Our VisionBy 2014 our distinct ability to deliver high quality individualized services inmodern living, learning and working environments will exceed stakeholderexpectations and secure Bancroft as the region’s elite provider of services topeople with intellectual and developmental disabilities and brain injuries. Our Core ValuesResponsible Empathetic Supportive Passionate Empowered Committed Trustworthy RESPECT2
  3. 3. 3
  4. 4. Why the increased focus onsports-related concussions? Concussions are common in sports, and their frequency appears to be increasing Although typically mild, sports concussions have a high risk of recurrence and can have significant complications Knowledge of the potential for long-term negative outcomes 4
  5. 5. What is a Concussion?A concussion ( or mildtraumatic brain injury) is acomplex physiologicalprocess affecting thebrain, induced bytraumatic biochemicalprocesses secondary todirect or indirect forces tothe head. 5
  6. 6. What is a Concussion?Disturbance of brainfunction is related toneurometabolicdysfunction rather thanstructural brain injury andis typically associated withnormal structural imagingfindings 6
  7. 7. What is a Concussion?Concussion may or maynot involve a loss ofconsciousness 7
  8. 8. What is a Concussion?Results in a constellationof physical, cognitive,emotional, and sleep-related symptomsSymptoms may last fromseveral minutes to days,weeks, months, or longerin some cases 8
  9. 9. Current Diagnosis of Concussion Does not require LOC Does not require a direct blow to the head Does not require amnesia CT/MRI likely to be normal 9
  10. 10. Sports and Concussions In the United States there are over 3.8 million sports related concussions a year. It is estimated that an athlete playing a contact sport has a 19% chance of suffering a concussion each year of play. 10
  11. 11. Sports and Concussions 34% of college football players have suffered at least one concussion. 20% of college football players have suffered multiple concussionsDepartment of Neurosurgery, University of Pittsburgh 11
  12. 12. Sports and Concussions All sports and recreation-related concussion in U.S. 1.6-3.8 million/year Concussion is COMMON in youth sports: 8.9% of high school athletes Concussions appear to be increasing, especially among high school athletesMeehan WP, et al. High School concussions in the 2008-2009 Academic Year: Mechanisms,Symptoms and Management. A J Sports Med.2010;38(12):2405-2409. 12
  13. 13. Sports and ConcussionsCommonly involve: Other players Falls on hard surfaces Equipment 13
  14. 14. “Limited Contact” Sports AlsoCarry a Risk of Concussion Baseball  Raquetball Bicycling  Ice Skating Cheerleading  Skateboarding Fencing  Snowboarding Flag Football  Softball Gymnastics  Squash Horseback Riding  Volley ball 14
  15. 15. Head Injuries Per Sport 2010 Cycling: 85,389 Football: 46,948 Baseball/softball: 38,394 Basketball: 34,692 Water sports: 28,716 Powered recreational vehicles: 26,606 Soccer: 24,184 15
  16. 16. Head Injuries Per Sport 2010 Skateboards/scooters: 23,114 Winter sports: 16,948 Horseback riding: 14,466 16
  17. 17. Gender Differences 17
  18. 18. Mechanism of Injury18
  19. 19. Mechanism of Injury19
  20. 20. 20
  21. 21. Pathophysiology 21
  22. 22. Metabolic Abnormalities Potassium, glutamate and glucose are immediately released from affected brain cells Calcium enters these disturbed cells Neurotransmitter release occurs with loss of autoregulation on the affected area Decreased cerebral blood flow 22
  23. 23. Neurometabolic Changes and Concussion 23
  24. 24. Injury Aftermath An energy crisis in the brain The brain is vulnerable to further damage 24
  25. 25. Emergency Symptoms Changes in alertness and consciousness Seizures Muscle weakness on one or both sides Persistent confusion Remaining unconsciousness (coma) Repeated vomiting Unequal pupils Unusual eye movements Walking problems 25
  26. 26. 26
  27. 27. Concussion Symptoms Headache  Feeling slowed down Nausea/Vomiting  Foggy Balance Problems/  Difficulty with Dizziness memory/concentration Fatigue/Drowsiness  Double vision Trouble sleeping  Ringing in ears Irritability/Sadness  Sensitivity to light/noise Nervousness/more emotional 27
  28. 28. Observed Signs of Concussion Appears dazed, stunned Confused about assignment/position Forgets an instruction Moves clumsily Answers questions slowly Loses consciousness (even briefly) Exhibits mood/ behavior/personality changes Can’t recall events before hit 28
  29. 29. Cumulative Effects Increased severity of symptoms with subsequent concussions Unknown effects on the developing brain 29
  30. 30. Second Impact Syndrome Experiencing a second concussion before signs and symptoms of a first concussion have resolved may result in rapid and typically fatal brain swelling. 30
  31. 31. Second Impact Syndrome Athletes should never to return to sports while theyre still experiencing symptoms of concussion. 31
  32. 32. Post Concussion Syndrome 20-25% of patients who suffer a concussion residual symptoms Estimated < 5% of sports related concussions 32
  33. 33. Post Concussion SyndromeSymptoms Headache Dizziness Sensitivity to light and sound Blurred vision Concentration, attention, and memory problems 33
  34. 34. Post Concussion Syndrome Most people recover fully from post concussion syndrome within 3-6 months. However, 7-15% of people will experience symptoms 1 year post injury. 34
  35. 35. Long Term Effects of Concussions  Chronic Clinical Changes seen in NFL players - Increased risk of cognitive impairment - Increased risk of depression  Chronic Traumatic Encephalopathy (CTE) - Damaged Tau Protein as seen in AD - Diagnosed in a college football player 35
  36. 36. 36
  37. 37. Concussion Management  ANY Signs or Symptoms: NO RETURN TO ANY SPORTS ACTIVITY  Rest  Gradual Return to Play 37
  38. 38. Clinical Dilemma of Concussion  There is no proven treatment-the injury must run its course  The severity of the concussion is not fully known until it has resolved  Uncertainty about when it is safe to return to competition 38
  39. 39. Concussion Management REMOVE athlete from play REFER to medical provider REST no sports, no texting, no tv RETURN only with medical clearance Children’s Hospital, Boston, Sports Concussion Clinic 39
  40. 40. We Don’t Know……  How many concussions are too many?  When the brain is really back to “normal”?  If pharmocotherapy could help?  Why are more injury prone? 40
  41. 41. Prevention  Teach safe techniques in practice and play  Encourage recognition and reporting of concussion symptoms  Be aware that injuries are more common in younger athletes 41
  42. 42. Prevention  Use available assessment tools  Monitor developments at advanced levels of play and legislative efforts  Head and spine injury prevention programs (Think First) 42
  43. 43. Education 43
  44. 44. 44
  45. 45. Videos About ConcussionsCan Be Seen On https://www.nanonline.org/NAN/_Research _Publications/Concussions_in_Sport.aspx 45
  46. 46. Resources  Mayo Clinic http://www.mayoclinic.com  The Center for Sports Concussion at Idaho State University www.knowconcussion.org  Center for Disease Control www.cdc.gov  Medicine Plus www.nlm.nih.gov  Sports Concussion Center of NJ http://www.sportsconcussionnj.com/?1f6c31 00 46
  47. 47. Resources Concussion tear-off pad: a resource for coaches, physical education teachers, school nurses, community youth sports personnel, and emergency response professionals. It is a pad of 50 sheets which can be torn off and sent home with parents or students. http://www.sportsconcussion.com/pdf/resource s/tear-off%20pad%202010.pdf 47
  48. 48. Thank you!48

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