The acute symptoms of concussion have been examined in many studies. Identifying the symptoms of concussion and the length of time these symptoms have been present will then allow the practitioner to apply a grade to the concussion. This loss of function will then result in characteristic features that identify TBI. These findings are definite indicators of a loss of neurologic function. Therefore “more force means more injury.” The duration of unconsciousness and duration of post-traumatic amnesia are probably the best indicators of the severity of the DAI. The magnitude of DAI changes are proportional to the deceleration force. The shearing forces generated in the brain by sudden deceleration most commonly cause DAI. The acute clinical symptoms of TBI usually reflect a functional disturbance secondary to structural damage to DAI. The neuropathology mechanisms of how TBI occurs are still being evaluated. When the brain absorbs energy that exceeds the ability of the body to dissipate the force of the energy successfully, tissue damage typically occurs. When there is trauma sufficient to result in diffuse axonal injury (DAI), it seems reasonable to anticipate there would be concomitant suboccipital and cervical spine problems that would be amendable to chiropractic methods. This is how passengers in a motor vehicle accident can sustain a TBI without actually striking their head. More than 250,000 concussions take place annually in football alone.1 The annual incidence of concussion for a single football player is typically identified in the literature as ranging from 3.6% to 47%.2 I recently studied the reporting instance of concussion in high school football players and found the incidence rate to be 65%.2 This study demonstrated a concussion occurrence rate that was much higher than the typically reported incidence rate.Īnother interesting fact about the mechanisms of injury was that concussion may be caused either by a direct blow to the head or by an impact elsewhere on the body, resulting in an impulse force transmitted to the head. The most common head injury in athletics is concussion. The International Classification of Diseases, Adapted code number for cerebral concussion is 85l.0.Īll DCs need to be alert for concussion symptoms, especially in the athlete. Remember to add this assessment to motor-vehicle-collision patients who cannot recall the events associated with the car accident when the loss of recall is related to head or neck trauma from the accident. A person does not need to be rendered unconscious to have sustained a concussion. When a person states he has had his “bell rung,” he has most likely sustained a concussion. The altered neuronal function includes such symptoms as alteration of consciousness, disturbance of vision, equilibrium and other similar symptoms. A concussion is defined as an immediate and transient impairment of neural function secondary to trauma. The study of concussion is still undergoing transition. Do not confuse the word “mild” with “insignificant.” All concussions are significant. The most common mild TBI is called a concussion. When evaluated, the patient has no focal signs of neurologic injury, although in the immediate post-traumatic period, patients may be pale, diaphoretic, nauseated, and ataxic.Whether the patient is briefly unconscious or not, confusion with amnesia is present for minutes to a few hours.A score of 13 or 14 is due to confusion or disorientation and will usually be associated with a longer period of amnesia. Only a score of 15 probably represents true mild TBI. The GCS is scored between 3 and 15, 3 being the worst, and 15 the best.
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