Concussion - ICEM 2016

Concussion:
The mild head injury paradox
Lindy-Lee Folscher
• Concussion is a mild head injury therefore
minor
• To have a concussion you need to be
knocked unconscious
• Helmets and mouth guards prevent most
concussions
• Boys suffer more concussions than girls
• Concussion symptoms are obvious as soon
as concussion occurs
“I was told not to worry
because it was JUST a
concussion”
Consensus Statement on Concussion in Sport.
4th International Conference on Concussion
in Sport held in Zurich November 2012.
Why is it important?
4,500 former NFL players have filed suit
TOTAL PAYOUT OF MORE THAN $870 MILLION
$675 million: compensatory claims for players
with neurological symptoms
43% of retired NFL players show traumatic brain
injury on neuroimaging
http://espn.go.com/nfl/story/_/id/11188140/us-district-judge-anita-brody-givespreliminary-ok-nfl-concussion-settlement
American Academy of Neurology 2016 Annual Meeting. Abstract 9071.
2017 USA President’s Budget is a
request from CDC for $5,000,000 to
establish and oversee a National
Concussion Surveillance System
http://www.cdc.gov/traumaticbraininjury/ncss/index.html
http://www.funnyjunk.com/funny_pictures/76449/Concussion/
Mechanism of Injury for TBI
Motor Vehicle Collisions
5%
Sports
10%
30%
Biking
10%
Medical
10%
Violence
15%
20%
Work place
Diving
Mc Crea HJ, Perrine K, Niogi S, Hartl, R. Concussion in
Sports. Sports Health. 2013;5(2):160-164.
http://concussion-talk.com/wp-content/uploads/2013/07/concussion-part2-1.jpg
http://www.cdc.gov/traumaticbraininjury/ncss/index.html
Recognition
https://mobilesim.files.wordpress.com/2011/05/head-and-chest.jpg
http://img.medscapestatic.com/pi/meds/ckb/54/37954tn.jpg
Fact:
Only 10% of ALL
Concussions result in a
loss of consciousness
Guskiewicz KM, Bruce SL, Cantu RC, Ferrara MS, Kelly JP, McCrea M, et al.
National Athletic Trainers’ Association Position Statement: Management of
Sports related concussion. J Athl Train. 2004;39(3):280-297.
http://www.advancedvisiontherapycenter.com
65% of concussion occur in children
between 5 & 18 years of age.
http://www.cdc.gov/traumaticbraininjury/ncss/index.html
Concussion and depression
18
16
% Depressed
14
12
10
16.5
8
11
6
4
5.5
2
0
At Least 1
3 or More
5 or More
Number of Concussions
Side line evaluation
Guskiewicz
KM,
Register-Mihalik
J,
McCrory P, McCrea M, Johnston K,
Makdissi M, et al. SCAT 3.
Br J Sports Med. 2013;47:259-262
http://www.cdc.gov/headsup/pdfs/providers/ace_care_plan_return
ing_to_work-a.pdf
http://www.sportsconcussion.co.za/Documents/PocketCardConcussion.pdf
Urgent CT Scan
Admit
Urgent Neurosurgical
Consultation
http://www.mybraintest.org
https://concussionu.files.wordpress.com
Benson BW, Hamilton GM, Meeuwisse WH, McCroy P, Dvorak J. Is protective equipment useful in preventing
concussion? A systematic review of the literature. Br J Sports Med. 2009;43(Suppl 1);i56-i67.
“Our goal isn't to just win the game.
Play so hard that your opponent loses
their next game as well. We expect it.
We demand it—for them to be that
way. Football is violent. It's a violent
sport. ” High School Football coach.
http://www.sportsconcussionaustralasia.com
http://www.sportsconcussion.co.za
http://www.cdc.gov/concussion/sports
http://boksmart.sarugby.co.za
http://playerwelfare.worldrugby.org/concussion
http://www.concussiontreatment.com
http://www.concussionwise.com
https://sportandrecreation.nsw.gov.au
http://bruisingthemelon.files.wordpress.com/2012/06/cartoon-of-concussion2.jpg