Concussion

Concussion:

  • Post-concussion syndrome: complex disorder in which various symptoms (headaches and dizziness) last for weeks and sometimes months after the injury that caused the concussion.
    1. Persistent worsening headaches and dizziness (post-concussion syndrome): Due to patient’s symptoms worsening and due to patient chronically being on Warfarin”
      1. A head CT without contrast is ordered.

Things to look for/ask about when assessing a patient following a concussion:

  • Headaches:
  • Dizziness:
  • Nausea/vomiting:
  • Blurry vision:
  • Sleep problems:

Table 3: Recommended Sequence for Return to Play Following a Concussion.

  1. No activity, complete rest. Once asymptomatic may proceed to step 2.
  2. Light aerobic exercise, no resistance training
  3. Sport-specific exercise
  4. Noncontact training drills
  5. Full contact training after medical clearance
  6. Game play

If any postconcussion symptoms occur during the above progression, the athlete should drop back to the previous level and try to progress again after 24 hours. From McCrory P, Johnston K, Meeuwisse W, et al. Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004. Br J Sports Med 2005;39:196-204.

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