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Traumatic Brain Injury - Concussion Syndrome

Q: Risk Factor for NCD secondary to TBI

Patient Factors Age: high-school age or younger , typically have longer recovery times (often a month or more) compared to college-aged or older adults. Pre-existing Mental Health . Co-morbid migraines Anticoagulant use Illness (Injury) Factors Repeat Concussions - within 10 days Initial Symptom Severity Mechanism of Injury: high-speed impacts , Environmental Factors Premature Return to Activity Sensory Overload: Immediate exposure to bright lights, loud noises, or crowded environments after the injury can aggravate symptoms and strain the autonomic nervous system

Q: Neuropsychiatric sequalae of Post Concussion Syndrome

1. Emotional and Affective Sequelae Post-Traumatic Depression Anxiety Disorders Irritability and Agitation Personality Changes increased impulsivity, apathy, or social inappropriateness, likely due to frontal lobe dysfunction. 2. Cognitive Impairment Attentional Deficits Executive Dysfunction: P rocessing Speed Memory 3. Sleep-Wake Disorders Insomnia Hypersomnolence: Circadian Rhythm Disruptions 4. Psychosis Delusions: persecutory or grandiose . Hallucinations: visual hallucinations are more common in PTP Onset Latency: Unlike somatic symptoms, psychosis often has a latent period .

Q: Red Flags of Post Concussion Syndrome

Loss of Consciousness: Any period of blacking out, no matter how brief. Extreme Drowsiness: Being very drowsy, having difficulty waking up, or being unable to be awakened. Significant Confusion: Inability to recognize familiar people or places, or feeling highly agitated. Abnormal Behavior: Engaging in unusual or 'different' behavior than normal for the individual. Profound Memory Loss: Inability to remember the time of the injury or the events that followed it

4 important questions on Traumatic Brain Injury - Concussion Syndrome

Define concussion and post concussion syndrome

Concussion : complex pathophysiological process that affects the brain and is induced by traumatic biomechanical forces

Post Concussion Syndrome :
concussion symptoms persist beyond the natural recovery period

The World Health Organization (WHO) suggests the term applies when symptoms last greater than one month.
The DSM-IV classification and other guidelines often require symptoms to persist for longer than three months before a formal diagnosis is made
in DSM-V, PCS falls under the category of Mild Neurocognitive Disorder (due to TBI)

Risk Factor for NCD secondary to TBI

Patient Factors

Age: high-school age or younger, typically have longer recovery times (often a month or more) compared to college-aged or older adults.
Pre-existing Mental Health.

Co-morbid migraines
Anticoagulant use

Illness (Injury) Factors

Repeat Concussions - within 10 days
Initial Symptom Severity
Mechanism of Injury: high-speed impacts,

Environmental Factors

Premature Return to Activity

Sensory Overload: Immediate exposure to bright lights, loud noises, or crowded environments after the injury can aggravate symptoms and strain the autonomic nervous system

Neuropsychiatric sequalae of Post Concussion Syndrome

1. Emotional and Affective Sequelae

Post-Traumatic Depression
Anxiety Disorders
Irritability and Agitation

Personality Changes increased impulsivity, apathy, or social inappropriateness, likely due to frontal lobe dysfunction.

2. Cognitive Impairment

Attentional Deficits

Executive Dysfunction:
Processing Speed
Memory

3. Sleep-Wake Disorders

Insomnia

Hypersomnolence:
Circadian Rhythm Disruptions

4. Psychosis

Delusions: persecutory or grandiose.

Hallucinations: visual hallucinations are more common in PTP

Onset Latency: Unlike somatic symptoms, psychosis often has a latent period.

Red Flags of Post Concussion Syndrome

Loss of Consciousness: Any period of blacking out, no matter how brief.
Extreme Drowsiness: Being very drowsy, having difficulty waking up, or being unable to be awakened.
Significant Confusion: Inability to recognize familiar people or places, or feeling highly agitated.
Abnormal Behavior: Engaging in unusual or "different" behavior than normal for the individual.
Profound Memory Loss: Inability to remember the time of the injury or the events that followed it