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SP5IC
11-08-2004, 17:30
How does one know if one has one? I am asking for an officer :)

Roguish Lawyer
11-08-2004, 18:55
How does one know if one has one? I am asking for an officer :)

Excellent question. :munchin

Doc
11-08-2004, 19:16
http://www.merck.com/mrkshared/CVMHighLight?file=/mrkshared/mmanual/section14/chapter175/175a.jsp%3Fregion%3Dmerckcom&word=concussion&domain=www.merck.com#hl_anchor

swatsurgeon
11-09-2004, 06:59
now for the important question...how severe was it?
We grade them according to severity (duration of unconsciousness and type of symptoms) and 'suggest' that patients with the more severe level of concussion NOT participate with driving, operating heavy machinery, firearms or explosives for a period of time.
It's a sad time when someone with sound medical knowledge "clears" someone to immediately return to a dangerous activity after a severe concussion....certain circumstances may dictate the need to return, i.e., hot zone in a sand box, but otherwise in civilian life they would be removed from their activity for a prescribed period of time for their safety as well as the safety of others. Anyone remember 2 yrs. ago in NASCAR, one of the big name drivers hit a wall, was unconscious for 3-5 minutes and they let him return to driving in a back up car!!!! he lasted about 2-3 more laps then drove into the pit area at about 180 mph....couldn't stop! I'll try to attach some stats and suggestions from a presentation I give on this.

swatsurgeon
11-09-2004, 07:17
Here are the clinical definitions and recommended Tx's....CIVILIAN WORLD!!!– Traumatic Brain Injury’s: Concussion

– Mild (grade 1)
 confusion with no amnesia or loss of consciousness
– Moderate (grade 2)
 confusion with amnesia, no loss of consciousness
– Severe (grade 3)
– any loss of consciousness

– Other nomenclature system
– mild :concussion
 at least one of these
– any LOC
– any amnesia
– any altered mental status
– any focal neurological deficit
– +/- transient symptoms
– moderate
 + LOC with prolonged confusion
– physical and/or cognitive and/or behavioral impairments
• +/- permanent
– severe
 coma/LOC: variable time
– likely permanent disabilities




Define the Treatments
 Grade 1 (confusion with no amnesia or LOC)
– if confusion clears within 20-30 minutes, than allow return to activity OR within 1 week of being without symptoms
– after a 2nd mild concussion in the same 6 month period, do not return to activity that may lead to another concussion for 2 weeks
 must be asymptomatic at least 1 week and have a negative CT scan
– if a third mild concussion occurs, terminate risky activities for the year
 may return next year if asymptomatic
– (?) neuropsychology evaluation
Define the Treatments
 Grade 2 (confusion with amnesia, no LOC)
– return to activity only after appropriate evaluation (CT scan, +/- neuropsych eval.) and asymptomatic for 1 week
– after 2nd moderate concussion, return to activity only after asymptomatic for 1 month and CT documented as normal
– if a 3rd occurs, terminate the activity for 1 year and consider termination of contact sports or other ‘high risk’ activities indefinitely
Define the Treatments
 Grade 3 (any LOC)
– urgent transport to trauma center
– may return to activity after asymptomatic for at least 2 weeks
 if LOC was < 1 minute and CT normal
– if LOC > 1 minute
 no return to high risk activity for 1 month and must be asymptomatic for at least 2 weeks
– if second episode LOC, terminate contact sports/high risk activity indefinitely

ccrn
11-09-2004, 13:44
‘No head injury is too trivial to ignore’ Hippocrates, 460–377 BC

The term consussion and mild traumatic brain injury (MTBI) are sometimes used interchangeabley.

However you want to call it they can have significant consequenses within the first year. A quick review of some CDC statistics reveals up to 15% experiencing some form of disability one year out. Divorce and job loss within the first year post MTBI has been studied also. In nursing school they gave us a figure on this but I recently through all of that out and no longer have the number. It did leave an impression though.

While George S Patton has admitted to manufacturing some of his WW2 personality in order to more effectively lead, some have speculated that consussions recieved while serving in the cavalry and playing polo contributed to changes in personality compare to his younger years.

A hx of consussions makes one more susceptible and is important to note in an h&p-

FWIW

Rumblyguts
07-13-2010, 09:49
Caught a little bit of this program on MN Public Radio. Only caught about 15 minutes, but the focus seemed to be on MBTI.

What cuaght my attention was how the concusion can be "transmitted" via blood pressure, and how the accumulation of "bell-ringers" from blasts add up (not sure if training was included, or jsut combat). I belive that she said that many of the participants had around 19 such instances.

One of the Dr's stated that her light-bulb moment occurred when she had several young soldiers come through who automatically pulled out notepads so they could remember the conversation.


Traumatic brain injuries: Wounds of a modern war
Broadcast: Midmorning, 07/13/2010, 9:06 a.m.
http://minnesota.publicradio.org/display/web/2010/07/13/midmorning1

The military has taken heat recently for its handling of soldiers and veterans with blast-induced traumatic brain injuries. Three leading TBI specialists discuss the difficulties of diagnosing and treating the disorder.

Guests
Ibolja Cernak, M.D.: Medical Director, Biomedicine Business Area, Johns Hopkins University Applied Physics Laboratory

Elaine Peskind, M.D.: Director of Clinical Research for Mental Health Services at the V.A. Hospital of Puget Sound, and a professor in the department of psychiatry at the University of Washington School of Medicine.

James Kelly, M.D.: Director of the Department of Defense's new National Intrepid Center of Excellence in Bethesda, Md.

wook
07-13-2010, 23:13
Potential for Second Impact Syndrome (diffuse cerebral swelling), is rare but often fatal effect from a second concussion before the symptoms of the first concussion have resolved.



Wook

MILON
07-14-2010, 11:15
Thanks for that post Rumblyguts. I listened to that program yesterday.

MPR and NPR has had quite a bit of coverage on head injuries sustained by soldiers, subsequent effects and issues the Army has in dealing with it.

Link below to a search on NPR.

http://www.npr.org/search/index.php?searchinput=Mild+Traumatic+Brain+Injury

Also some stuff on Frontline's Website.

http://www.pbs.org/wgbh/pages/frontline/gsearch.html?q=mild+traumatic+brain+injury

Milon

MILON
07-29-2010, 20:05
Soldiers with Brain Injuries at Higher Risk for Epilepsy Decades Later

http://www.newswise.com/articles/view/566431/?sc=dwhp

Rumblyguts
05-30-2015, 18:44
Folks,

Our 9 year old son took a point blank soccer ball to the head that lifted him off his feet and put him on the ground. Times have changed since I was kid getting knocked-out, and when I had some wilderness first responder courses. We're trying to figure out whether or not to take him to the Dr.

Facts
He remembers the incident, but not hitting the ground.
Appeared to be conscious within a few seconds after hitting ground.
Impaired vision for roughly 5 minutes after (could track a finger, but reported wrong number of fingers
Answered questions coherently
Did not report any nausea, dizziness, numbness, etc.

A nurse on-hand said that he had a mild concussion and should be OK. Just watch for symptoms as time goes on. No screens, calm both mentally and physically, etc.

We're at 10 hours post incident and still looking for symptoms (memory, emotions, pains). Nothing showing. If memory serves, we're still in the 24 hr swelling window.

Break

Reading around, it seems that any concussion should be seen by a doc. Then there are varied times of recovery, and once symptom-free, a graduated process for increasing cognitive and physical activity.

We're looking to keep him low-key for the next couple days, and have him avoid activity that could smack his head for the next week (including soccer).

What are we not thinking about, missing, etc.? Also confused about the "grade". Trying to make that parental of going to the doc...

Thanks for any guidance.
Rumbly

Red Flag 1
05-30-2015, 19:46
I hope everything is OK.

Rumblyguts
05-30-2015, 19:48
Wilco

Longstreet
05-30-2015, 21:24
This is something you may want to look into. It is not a total solution, but may help if your son has any future blows to the head when playing sports.

http://www.reebok.com/us/checklight

I cannot remember where I learned about this device. My apologies if it was from an old thread from this site.

My children are still too young for such a device, but I will be looking into such technology when the situation presents itself. There was a radio show I listened to a few years ago and it claimed that some people are more susceptible to conclusions due to genetics and that it is only a matter of time before people will be able to test for the gene. You may want to do some research on this.

Rumblyguts
05-31-2015, 08:35
24 hours, no symptoms.

Talking more with my wife, it turns out that the "nurse" is the clinic's PA-C who specializes in childhood medicine and works the urgent care. Wife contacted her last night for further guidance. Quiet again today and regular activity tomorrow. Son's "regular" activity is rough, so we'll be sending a note to school for sitting out.

We're thinking that her info is the same as we'd get if we went to the clinic, so we'll be staying put. Marriage is compromise; wife ain't budgin'

Thank you for your time.

Guymullins
06-01-2015, 10:50
I had a strange and disconcerting experience with concussion a few years ago. I had meant to retire from competitive skydiving that year, but had been persuaded to do a last year of hardcore training and participate in the National Champs in the 8 Way RW competition. This was a combination of my old team, that had won the competition for the last four years and our old arch-foes who had always come second, so it wasn't a clear cut winning team and the competition was going to be close among the top five teams.
I had a pressing business engagement and was only able to get to the DZ on the last day of practice. After a four hour drive, I arrived just in time for the lat practice dive before the competition (a reserve had down the previous jumps).
It was a military DZ way out in the flat Free State plains over which the wind howled most of the year. A line of high pine trees ran alongside the runway and sheltered the team tents.
Rushing through the walk through, I had no time to familiarise myself with the DZ.
We ran for the jumpship and climbed aboard the military DC3. The jump went well and on break off, I looked around and saw the DZ and runway with the windsock alongside it. Not really paying much attention I turned on a final approach that would allow me to glide in next to the line of trees and land alongside the tents.
As I began my flair, I hit some quite serious turbulence coming off the trees and had a pretty hard landing, head over heals in a ball of dust on the hard ground.
I had bashed my hockey helmeted head on the ground, but in no way disturbing to me. I got up and immediately packed my parachute and sank a beer while we discussed where we would go to eat in town.
A few hours later, after a refreshing shower, we all trekked off to an Italian restaurant in town. I was feeling fine, and had sunk a few more beers in the interim.
Our meals arrived and just as the waiter served me, I had a really horrible sensation as I was sitting at the table. The best way of describing it is I was sure I was dying and I passed out, head first in a bowl of hot spaghetti Carbonara.
There was a doctor also eating in the restaurant and he treated me as if I had suffered a heart attack. I came round, very disorientated a few minutes later and an ambulance rushed me off to a teaching hospital nearby.
A professor examined me and said that it seemed that my heart was fine, but I had some high pressure behind the eye-balls signifying a severe concussion.
Casting my mind back, all I could think of was the hardish landing I had that afternoon.
Anyway, he said that I should remain under observation for a couple of days.
Of course, the competition was starting early the next morning and I was worried that I would let my team down. Although I was feeling a bit woozy, I called a teamate very early the next morning , telling him that I had been discharged and I climbed out the ward window and got taken back to the DZ. What followed was a very nervous ten competition jumps over the following few days. These were the days before AODs, so I told my team mates to keep a sharp eye on me in free fall, and if I looked dozy, they should please pop my reserve for me.
The anxiety that another period of unconsciousness made the plane rides a bit of a trial for me, but once out of the plane in free fall, the concentration needed for the jumps took my mind off the risk.
Fortunately, there was no recurrence of unconsciousness and my team went on to win the competition and I retired from competition right after the meet.

Austin94
03-05-2017, 22:37
Thanks for this information