CEREBRAL

CONCUSSION
Group I-3:
Leader: Marpuri, Argie T.
Members: Alaro, Airalyn C.
Riparip, Clarisse A.

CEREBRAL CONCUSSION: Definition

A concussion after a head injury is a
temporary loss of neurologic function with
no apparent structural damage to the
brain.

CEREBRAL CONCUSSION: Definition

A concussion (also referred to as a mild TBI)
may or may not produce a brief loss of
consciousness. The mechanism of injury is
usually blunt trauma from an
acceleration-deceleration force, a
direct blow, or a blast injury.

CEREBRAL CONCUSSION: Definition

There are three grades of concussion or mild TBI defined
by the American Academy of Neurology when the injury
is sport related:
Grade 1 concussion: symptoms of transient confusion,
no loss of consciousness.
Grade 2 concussion: symptoms of transient confusion
and no loss of consciousness.
Grade 3 concussion: no loss of consciousness.

CEREBRAL CONCUSSION: Definition

The duration of mental status abnormalities is an
indicator of the grade of the concussion.
Monitoring includes observing the patient for a
decrease level of consciousness (LOC),
worsening headache, dizziness, seizures,
abnormal pupil response, vomiting, irritability,
slurred speech, and numbness or weakness in
the arms or legs.

CEREBRAL CONCUSSION: Definition

Recovery may appear complete, but long-term
sequelae are possible and repeat injuries
common. Problems at work and at home can
result in interpersonal relationship problems or
the loss of employment. The family and patient
are instructed to follow up with the primary
provider.

CEREBRAL CONCUSSION: Causes

The brain has the consistency of gelatin. It's
cushioned from everyday jolts and bumps by
cerebrospinal fluid inside the skull. A violent blow
to the head and neck or upper body can cause
the brain to slide back and forth forcefully
against the inner walls of the skull.
Sudden acceleration or deceleration of the head,
resulting from certain events such as a car crash
or being violently shaken, also can cause brain
injury.

CEREBRAL CONCUSSION: Causes

These injuries affect brain function, usually for a
brief period, resulting in signs and symptoms of
concussion.
A brain injury of this sort may lead to bleeding in
or around the brain.
Such bleeding in the brain can be fatal.

Statistical Data
Prevalance of Traumatic Brain Injury:
0.2% of population has an acquired brain injury in
Australia 1998 (Australias Health 2004, AIHW)
Prevalance Rate for Traumatic Brain Injury:
Approximately 1 in 500 or 0.20% or 544,000 people in
USA

Statistical Data

Statistical Data

Medical-Surgical Management
Physical and neurological examinations
CT and MRI scans
Positron emission tomography (PET)
A flow chart developed by the Brain Trauma Foundation
(2007) for the initial management of brain injury is
presented below.

Initial management
Severe head injury
GCS8 or less

ATLStrauma evaluation

Emergency diagnosis or
therapeutic procedures
as indicated

Endotracheal intubation
Fluid resuscitation
Ventilation (PaCO2 35
mmHg)
Oxygenation
Sedation
+Pharmacologic paralysis
(short acting)

Herniation?*
Deterioration?*

+Hyperventilation*
+Mannitol (1g/kg)*

CT scan

Resolution?

Surgical lesion?

Intensive care unit

Monitor ICP

Treat intracranial
hypertension

Operating room

Diagnostics
A blow to the head, neck or upper body can cause a
concussion.
The doctor will evaluate the signs and symptoms,
review medical history, and conduct a neurological
examination.

Diagnostics
Tests the doctor may perform or recommend include:
1. Neurological examination
After the doctor asks detailed questions about the injury, he or she
may perform a neurological examination. This evaluation includes
checking the patients:
Vision
Hearing
Strength and sensation
Balance
Coordination
Reflexes

Diagnostics
The doctor may conduct several tests to evaluate the patients
thinking (cognitive) skills during a neurological examination.
Testing may evaluate several factors, including:
Memory
Concentration
Ability to recall information

Diagnostics
2. Imaging tests
Brain imaging may be recommended for some people with
symptoms such as severe headaches, seizures, repeated
vomiting or symptoms that are becoming worse. Brain imaging
may determine whether the injury is severe and has caused
bleeding or swelling in the skull.
A cranial computerized tomography (CT)
Magnetic resonance imaging (MRI)

Diagnostics
3. Observation
Patient may need to be hospitalized overnight for observation
after a concussion.
If the doctor agrees that he may be observed at home, someone
should stay with the patient and check on him for at least 24
hours to ensure the symptoms aren't worsening. A caregiver may
need to awaken the patient regularly to make sure he can
awaken normally.

NURSING CARE PLAN