Sports Medicine HEAD Injuries

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Sports Medicine HEAD Injuries

• CHAPTER 22

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Vocabulary

• Occlusion
• Malocclusion
• Epistaxis
• Cauterization
• hyphemia
• Hematoma auris
• Nystagmus
• Keloid
• Photophobia
• External Otitis
• Orbital Hematoma

•  Encephalon
• Meninges
• Cerebrospinal fluid
• Automatism
• Posttraumatic amnesia
• Retrograde amnesia
• Intracranial hemorrhage
• Tinnitus
• Rhombergs sign
• Cerebral hyperemia
• Cerebral edema

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ANATOMY--

• HEAD-bones of skull
•  scalp is the first line of defense
• Bones of the skull makes up the second line of
  defense for the brain
•  28 bones in the skull
•  Frontal, temporal, parietal, occipital
• MENINGES- skull matter
• Protective coverings that enclose the spinal cord
  and the brain. Their primary functions are to
  channel forces away from the vital structures and
  provide a passage way for blood vessels,
  lymphatic vessels and nerves

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The meninges

• Dura mater
• Superficial lines against the skull. It is the
  toughest and contains blood vessels and nerves
• Arachnoid mater
• Netlike structure, forming a web over the brain
• Pia mater
• Deepest and follows all the irregular contours of
  the brain

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MECHANISM OF INJURY

• Direct blow-
• thin bone produces local trauma in
  bending/tensile stress inner table
• Thick bone non trauma local in bending/tensile
  stress with peripheral out bending/tensile stress
  with peripheral out bending outer table
• Size of impact smaller more serious than large
  surface area

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MECHANISM OF INJURY

• Coup injury- a forceful blow to the resting
  moveable head usually produces maximal brain
  injury beneath the point of cranial impact
• Contra coup injury- when a moving head collides
  with a nonmoving object producing maximal brain
  injury to the opposite site of cranial impact

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Injuries to the Head

• Subdural Hematoma
• Involves veins in the brain.
• Usually tear the bridge between the dura mater
  to the brain.
• Contra coup type of an injury.
• Hemorrhage is slow and should be watched very
  closely for 24 hours
• Epidural hematoma
• Common with a temporal skull fx.
• Artery- rapid bleeding
• Brief period of unconsciousness followed by
  consciousness to coma to death within a period of
  15-30 min.

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Injuries to the Head

• Intracerebral bleeding
• Bleeding within the brain itself
• Deterioration of neurological function occurs
  rapidly
• Skull fractures
• Severe blow to head
• Difficult to determine even by x-ray
• Watch for intracranial bleeding signs

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Concussions
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Definition of Concussion

• Any alteration in cerebral function caused by a
  direct or indirect (rotational) force transmitted
  to the head resulting in one of the following
  acute signs or symptoms
• Brief loss of consciousness
• Light-headedness
• Vertigo (dizziness)
• Cognitive or memory dysfunction

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Signs/symptoms cont. concussion

• Tinnitus (ringing in the ears)
• Blurred vision
• Difficult concentrating
• Amnesia
• Headache
• Nausea and vomiting
• Photo-phobia
• Balance disturbance

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Signs/symptoms cont. concussion

• Delayed Signs and Symptoms
• Sleep irregularities
• Fatigue
• Inability to perform usual daily activities
• Depression
• Lethargy

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Facial Injuries

• Jaw fracture
• Second to all facial fractures
• Most common fx near jaws frontal angle
• Deformity or malocclusion
• Pain when biting down
• Bleeding around teeth
• Lower lip numbness
• Cheekbone fx. (zygomatic)
• Around the eye, 3rd most common facial injury
• Loss of vision

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Facial Injuries

• Teeth injuries
• If dislocated replace in socket
• Enamel is the hardest substance within the body
• Fractured nose
• Most common fx. To the face
• RX control bleeding- x-ray
• Have athlete sit upright
• Cold compress
• Direct pressure to nostril
• Cauliflower ear hematoma auris
• Cold compress
• Possible drain and cast
• Wear protective ear covering

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Eye injuries

• Symptoms indicating serious eye injury
• Blurred vision not clearing with blinking
• Loss of all or part of the visual field
• Pain that is sharp, stabbing, or throbbing
• Double vision
• RX cover both eyes but put no pressure on the
  eye
• Transport to hospital

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Eye injuries

• Blowout fracture
• Hemorrhage occurs around the inferior aspect
  margins of the eye
• Diplopia
• Pain while moving eye
• Retinal detachment
• More common with myopia (nearsightedness)
• Seeing specks floating before the eye
• Flashes of light
• Blurred vision
• Curtain falling over the field of vision