Injuries to the head and brain

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Injuries to the head and brain

  1. 1. 1<br />Injuries to the Head and Brain<br />
  2. 2. Houses and Protects the Brain<br />Parts of It!<br />Occipital*<br />Frontal*<br />Parietal*<br />Temporal*<br />Squamos (Ear)<br />Mandible*<br />Maxilla*<br />Zygomatic*<br />Nasal*<br />2<br />The Skull<br />
  3. 3. Cushioned in a dense membrane called Cerebrospinal Fluid<br />Produced by the Brain<br />Clear and Colorless<br />Circulates and Protects throughout the Skull and Spinal Column<br /> Reabsorbed by the Circulatory system<br />Enough cerebrospinal fluid to fill a soft drink can (about 350 cubic centimeters) is reabsorbed and replenished daily<br />Combats infection and cleansing the brain and spinal column<br />Skull or Membrane are broken – CSF leaks out – often through the nose and or ears<br />3<br />The Brain<br />
  4. 4. Brain is protected by 3 layers<br />Dura Mater – “Hard Mother”<br />Arachnoid – Spider Web effect<br />Pia Mater – “Soft Mother”<br />4<br />The Meninges<br />
  5. 5. Regulates & Coordinates the bodies activities<br />Primary Organ of the Nervous System<br />Responsible for:<br />Receiving sensory impulses<br />Interpreting Sensations<br />Forming perceptions:<br />THOUGHT<br />SPEECH<br />ACTION <br />EMOTION<br />MEMORY<br />REASON<br />JUDGEMENT<br />5<br />What Does the Brain Do?<br />
  6. 6. Extends from the Central Nervous System (CNS) to EVERY part of body <br />the information pathways<br />Sensory impulses travel to and from the CNS<br />The brain then generates an appropriate motor response from the body<br />Moving away from a source of perceived heat <br />or responding to a question.<br />Injuries that involve the brain must be taken seriously.<br />6<br />Peripheral Nervous System<br />
  7. 7. 7<br />Part of the nervous system formed by all the motor or sensory nerves (43 pairs) connecting the central nervous system to the organism. <br />
  8. 8. Brain contains specific blood vessels:<br />Arteries = transport the blood and its nutrients to the brain<br />Veins = blood vessels that transport blood containing waste products away from the brain<br />Is Blood Important to the brain?<br />It’s Necessary<br />in order to provide ALL of the brain cells with: <br />OXYGEN<br />GLUCOSE<br />Interruption to ANY part of the brain may result in a “BRAIN INJURY”<br />Any type of brain injury can result in:<br />Accumulation of Waste products<br />Carbon dioxide<br />Lactic acid<br />In turn - Causes Swelling<br />8<br />Blood Supply <br />
  9. 9. 9<br />Mouth Pieces <br />Dual composite construction. <br />Shock absorbing jaw pads helps protect against concussions and create a channel for improved breathing. <br />Front bumper absorbs and deflects impact ways from teeth. <br />Quick-Release helmet tether. <br />
  10. 10. What happens when the Brain swells?<br />Increased Pressure within the skull<br />Increased intracranial pressure<br />Due to excessive blood<br />Excessive production of Cerebrospinal fluid<br />Swelling Reduces BLOOD SUPPLY<br />Leading to further complications<br />Brain damage<br />DEATH<br />10<br />
  11. 11. 11<br />
  12. 12. Brain injuries occur as a result of a direct blow, or sudden snapping of the head forward, backward, or rotating to the side<br />May or may not result in loss of consciousness, disorientation or amnesia; motor coordination or balance deficits and cognitive deficits<br />May present as life-threatening injury or cervical injury (if unconscious)<br />12<br />Assessment of Head Injuries<br />
  13. 13. Determine loss of consciousness and amnesia<br />Additional questions (response will depend on level of consciousness)<br />Do you know where you are and what happened?<br />Can you remember who we played last week? (retrograde amnesia)<br />Can you remember walking off the field (antegrade amnesia)<br />Does your head hurt?<br />Do you have pain in your neck?<br />Can you move your hands and feet?<br />13<br />HISTORY<br />
  14. 14. Is the athlete disoriented and unable to tell where he/she is, what time it is, what date it is and who the opponent is?<br />Is there a blank or vacant stare? Can the athlete keep their eyes open?<br />Is there slurred speech or incoherent speech?<br />Are there delayed verbal and motor responses?<br />Gross disturbances to coordination?<br />14<br />OBSERVATION<br />
  15. 15. Inability to focus attention and is the athlete easily distracted?<br />Memory deficit?<br />Does the athlete have normal cognitive function?<br />Normal emotional response?<br />How long was the athlete’s affect abnormal?<br />Is there any swelling or bleeding from the scalp?<br />Is there cerebrospinal fluid in the ear canal?<br />15<br />
  16. 16. Palpation<br />Neck and skull for point tenderness and deformity<br />Special Tests<br />Neurologic exam<br />Assess cerebral testing, cranial nerve testing, cerebellar testing, sensory and reflex testing<br />Eye function<br />Pupils equal round and reactive to light (PEARL)<br />Dilated or irregular pupils<br />Ability of pupils to accommodate to light variance<br />Eye tracking - smooth or unstable (nystagmus, which may indicate cerebral involvement)<br />Blurred vision<br />16<br />PALPATIONS & SPECIAL TESTS<br />
  17. 17. Balance Tests:<br />Romberg Test<br />Assess static balance - determine individual’s ability to stand and remain motionless<br />Tandem stance is ideal<br />Coordination tests:<br />Finger to nose, heel-to-toe walking<br />Inability to perform tests may indicate injury to the cerebellum<br />17<br />Concussions in Football - National Athletic Training Month, March 2010<br />http://www.youtube.com/watch?v=MWeMuFoOIpU<br />
  18. 18. COGNITIVE TESTS<br />Used to establish impact of head trauma on cognitive function and to obtain objective measures to assess patient status and improvement<br />On or off-field assessment<br />Serial 7’s, months in reverse order, counting backwards<br />Tests of recent memory (score of contest, 3 word recall)<br />Neuropsychological Assessments<br />Standardized Assessment of Concussion (SAC) provides immediate objective data concerning presence and severity of neurocognitive impairment<br />18<br />
  19. 19. TYPES OF CONCUSSIONS<br />Define Concussion?<br />Agitation or a Shaking from being hit<br />Causes immediate symptoms:<br />Headache<br />Major complaint<br />Dizziness<br />Nausea- <br />Caused by swelling of the brain<br />Release of neuro chemicals <br />Symptoms of Disorientation<br />Confusion <br />Confusion resulting from swelling at point of contact.<br />Observe Mood Changes<br />Injury causes a temporary STOPPAGE in the blood supply to the brain.<br />19<br />
  20. 20. Biomechanical effect on the brain<br />Disruption of function<br />Series of changes in the nerve cells that cause a disruption<br />Wave propagates<br />Discharge of chemical and electrical discharge across the cortex<br />Shears the nerve cells (swell)<br />Affects the anatomy of that cell<br />20<br />Brain Dysfunction<br />
  21. 21. Postconcussion Syndrome<br />Follows a concussion (Mild)<br />Signs:<br />Persistent headache<br />Impaired memory<br />Lack of concentration<br />Anxiety / irritability<br />Giddiness / Fatigue / Depression <br />Visual disturbances<br />21<br />
  22. 22. SECOND IMPACT<br />Rapid swelling because previous concussion did not resolved.<br />Caused by relatively minor blow to the head/chest/back.<br />Increased symptoms w/in 15 seconds<br />The shock can lead to SERIOUS complications and may be FATAL.<br />22<br />
  23. 23. Cerebral Contusion<br />Small hemorrhages or Intracerebral Bleeding within Cortex or Brainstem or Cerebellum<br />Head strikes stationary immovable object<br />Signs:<br />LOC (loss of consciousness)<br />Become very alert/talkative<br />Neuro exam is normal<br />Headaches, dizziness and nausea PERSIST<br />23<br />
  24. 24. Epidural Hematoma (Cerebral)<br />Blow to the head – resulting in Skull Fracture<br />Causes tear in meningeal arteries.<br />Bleeding occurs extremely fast <br />Signs:<br />LOC<br />Lucid <br />Gradually symptoms worsen<br />Severe head pains,<br />Dizziness / nausea<br />Dilation of one Pupil<br />Deteriorating consciousness<br />Neck rigidity<br />Depression of pulse/respiration <br />Convulsions <br />LIFE THREATHENING <br />24<br />
  25. 25. 25<br />
  26. 26. Subdural Hematoma<br />Occur more frequently<br />Acceleration – deceleration forces<br />Tear vessels that bridge the dura mater and brain<br />Involve venous bleeding<br />Symptoms appear more slowly (hours<br />Signs:<br />LOC w/ one pupil dilated (same side as injury)<br />Headache, dizziness, nausea, sleepiness<br />LIFE THREATENING<br />26<br />
  27. 27. SUBDURAL HEMATOMA<br />27<br />
  28. 28. 28<br />
  29. 29. NOT ALL ATHLETES REPORT CONCUSSIONS<br />Be Aware of the Following:<br />29<br />
  30. 30. 30<br />
  31. 31. HELMETS<br />31<br />
  32. 32. Student Enrichment Activities<br />Get in groups of 4’s<br />Each group will take two (2) Assessment sheets<br />Put your names on one (1) of the sheets<br />You will be given different Standardized tests<br />Verbal learning<br />Stroop Color Word <br />Digits backward / forward<br />Symbol identification <br />Record your comments <br />32<br />

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