Leininger physiatric approach to concussion

Not all Bells are Meant to be Rung September 29, 2011 Kirk Leininger, MD

Head injuries in the workplace

TRAUMATIC BRAIN INJURY ,[object Object],[object Object],[object Object],[object Object]

ANNUAL INCIDENCE RATES OF MEDICAL CONDITIONS IN US ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Concussion is a Latin word meaning “collision.” ,[object Object]

OPEN vs CLOSED BRAIN INJURY ,[object Object],[object Object]

VISIBLE BRAIN LESIONS ,[object Object],[object Object]

CASE STUDY #1 ,[object Object],[object Object],[object Object]

CASE STUDY #1 cont. ,[object Object],[object Object],[object Object],[object Object]

CLOSED HEAD INJURY MAY CAUSE FRACTURE OR BLEED ,[object Object],[object Object],[object Object],[object Object],[object Object]

YOU CANNOT SEE A CONCUSSION ,[object Object]

CONCUSSION ,[object Object],[object Object]

PATHOPHYSIOLOGY OF CONCUSSION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CONCUSSION CRITERIA ,[object Object],[object Object],[object Object],[object Object]

CONCUSSION EVAL ,[object Object],[object Object],[object Object],[object Object]

SYMPTOMS OF CONCUSSION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

SIGNS OF CONCUSSION ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ASSESSMENT OF CONCUSSION ,[object Object],[object Object],[object Object],[object Object],[object Object]

PREDICTING OUTCOMES AFTER CONCUSSION ,[object Object],[object Object],[object Object],[object Object]

PREDICTING OUTCOMES ,[object Object],[object Object]

PREDICTING OUTCOMES ,[object Object],[object Object],[object Object]

PREDICTING OUTCOMES ,[object Object]

CASE STUDY #2 ,[object Object],[object Object],[object Object],[object Object]

CASE STUDY #2 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CASE STUDY #2 ,[object Object],[object Object],[object Object],[object Object],[object Object]

THE CHALLENGE WITH CONCUSSION ,[object Object],[object Object],[object Object],[object Object],[object Object]

VULNERABILITY OF BRAIN AFTER INJURY ,[object Object],[object Object],[object Object],[object Object]

SECOND IMPACT SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

EXPECTED RECOVERY FROM CONCUSSION ,[object Object],[object Object],[object Object],[object Object]

POST CONCUSSIVE SYNDROME ,[object Object],[object Object],[object Object],[object Object],[object Object]

POST CONCUSSIVE SYMPTOMS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

PCS – 4 AREAS OF INVOLVEMENT ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

COGNITIVE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

COGNITIVE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

SOMATIC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

SOMATIC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

HEADACHE MEDICATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

HEADACHE MEDS CONT. ,[object Object],[object Object],[object Object]

MOOD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

MOOD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

SLEEP ALTERATION ,[object Object],[object Object],[object Object],[object Object]

SLEEP ALTERATION: Adverse effects ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

SLEEP ALTERATION: Causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

SLEEP ALTERATION: Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

RETURN TO WORK/SCHOOL ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

RETURN TO WORK/SCHOOL ,[object Object],[object Object],[object Object]

IS POST-CONCUSSIVE SYNDROME REAL? ,[object Object]

DTI: Diffusion Tensor Images ,[object Object],[object Object],[object Object]

YES, POST CONCUSSION SYNDROME IS REAL ,[object Object],[object Object]

Leininger physiatric approach to concussion

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