Traumatic brain injury

Epidemiology

• Approximately 1 in 24 deaths are due to head trauma
• Peak age 15-24 years old due to motor vehicle collisions, with a slight peak in the elderly
• Ratio of males:females is 2-3:1

Red Flags

• Prolonged loss fo consciousness
• Any focal neurological symptoms
• Increasing headache
• ......
• .... ...
• Suspicion of a skull fracture

Management

• Acute
  • ABCs
  • Collar and backboard for spine immobilization
  • GCS assessment
  • Assess associated injuries
  • CT head +/- plain film of C-spine
• Concussion
  • Rest until patient is asymptomatic, then gradual return to play with at least 1 day between advancing along each of the following steps:
    • Complete rest
    • Light aerobic exercise
    • Activity-specific training without contact
    • Drills without body contact
    • Drill with body contact
    • Game play