NR 603 Week 1 Discussion Comparison And Contrast : Concusive Syndrome And Traumatic Brain
Injury
Hello Professor and class,
I will compare and contrast post concussive syndrome and traumatic brain injury.
Presentation (demographics, onset of symptoms, associated risk factors)
Post-Concussive Syndrome
Post-concussion syndrome is a term used to indicate a group of symptoms that occur after a
concussion (Bramley et al., 2016). Most individuals can recover from a concussion within 7-10
days, but those that do not recover within the usual time, they have PCS. This can happen to
anyone. Risk factors include previous concussions and preinjury mental health problems,
particularly depression (Iverson et al., 2017). PCS falls into one of four categories: vestibular
(imbalance, nausea, dizziness), sensory (blurry vision, migraines, tinnitus, photo/phonophobia),
cognitive (difficulty focusing, forgetfulness), and emotional (fatigue, insomnia, irritability,
depression) (Quin et al., 2018).
TBI
In 2014, there were about 2.87 million TBI-related ED visits, hospitalizations, and deaths that
occurred in the United States (Centers for Disease Control and Prevention, 2019). Sports and
recreational activities contribute to about 21 percent of all TBIs among American children and
adolescents. The American Congress of Rehabilitation Medicine defines traumatic brain injury
that results in the following, if present:
1) loss of consciousness for up to 30 minutes
2) alteration of consciousness for less than 24 hours
3) posttraumatic amnesia for less than 24 hours
4) a Glasgow Coma Scale score of 13–15 at 30 minutes after injury (Quinn
et al., 2018, pg. 104).
Signs and symptoms may appear within 24 hours or may emerge days or weeks after the injury
(Quinn et al., 2018). Risk factors for TBI are individuals 75 years of age and older, falls, and
motor vehicle accidents (CDC, 2019).
Pathophysiology
Post-Concussive Syndrome
The pathophysiology of post-concussion syndrome is a combination of metabolic, physiology,
and microstructural injuries to the brain. When head trauma produces a change in neurologic
function, neurochemical changes occur (Mullally, 2017). There is a release of excitatory
neurotransmitters, glutamate binding to N-7methyl-D-aspartate receptors in particular, which
causes a release of potassium into the extracellular space and then an influx of calcium going
into the cell. This creates a transient hypermetabolic glycolytic state – lactate is produced,
impairing neuronal function, and blood flow is reduced, and glucose utilization is diminished
(Mullally, 2017). Symptoms consistent with post-concussion syndrome result from autonomic
nervous system damage. This damage occurs to the white matter tracks between cortical control
centers and vagal nerve control via the spinal cord. Damage to the autonomic nervous system
also causes difficulties with control of cerebral blood flood, blood pressure and heart rate leading
to dizziness, headache, confusion, and difficulty with concentration (Mullally, 2017).
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, TBI
TBI occurs when a traumatic event causes the brain to move rapidly within the skull, leading to
damage. The pathophysiology of TBI is a complex process that results from primary and
secondary injuries. Primary injury is directly caused by mechanical forces during the initial
insult. This occurs at the moment of trauma and includes contusion, damage to blood vessels,
and axonal shearing, where the axons of neurons are stretched and torn (Ng & Lee, 2019). The
blood brain barrier and meninges may be damaged, and neurons may die. Neuronal cell death
causes cerebral edema which raises intracranial pressure and causes brain damage (Pavlova et
al., 2018). The primary injury leads to secondary injury, which results from processes initiated by
the trauma. After the injury, the cerebral injury is illustrated by extreme tissue harm and
diminished metabolism and cerebral blood flow regulation (Pavlova et al., 2018). This produces
an ischemia-like condition, resulting in anaerobic glycolysis. Lactic acid accumulates and
membrane permeability increases, resulting in edema formation (Pavlova et al., 2018). Damage
to the blood brain results in the inactivation of free radial scavengers and the opening of ion
channels causing an influx of calcium. Two events occur – the first is cerebral edema occurs,
raising intracranial pressure and causing brain damage (Pavlova et al., 2018). The second is the
generation of free radicals, which impairs cerebral vasoregulation; therefore, reducing cerebral
blood flow, resulting in brain damage (Pavlova et al., 2018).
Assessment (physical assessment, diagnostic testing)
Post-Concussive Syndrome
Post-concussive syndrome is a sequela of a concussion. Symptoms of post-concussive syndrome
are headache, dizziness, vertigo, fatigue, memory problems, sleeping troubles, and trouble
concentrating (Polinder et al., 2018). A medical history should include history of previous TBIs,
head and neck injuries, and a detailed description of the number and extent of previous
concussions. A neurological exam should be completed, involving the orientation, speech,
concentration, memory, motor, sensory, and gait assessment (Polinder et al., 2018). Assessment
of depression, anxiety, stress, and mental health problems should be done. As for neuroimaging,
there is no consensus on whether imaging is necessary; however, some images of patients with
post-concussion symptoms have shown structural or functional abnormalitites (Polinder et al.,
2018)
TBI
An individual with TBI may present with vomiting, lethargy, headache, confusion, loss of
consciousness, vision changes, dizziness and balance problems, slow pulse, slow breathing rate,
speech difficulties, and loss of bladder or bowel control (Prince & Bruhns, 2017). A
neuropsychological evaluation is done to assess the cognitive and functional deficits results from
a neurological injury or disorder. A thorough exam is conducted to review the presenting
condition and associated symptoms. The Glasgow Coma Scale (GCS) is the most commonly
used assessment scale to grade the severity of the trauma (McKee & Daneshvar, 2015). It is
based on a 15-point scale: Score of 13-15 is mild, 9-12 is moderate disability, 3-8 is severe
disability, and less than 3 is vegetative state. CT scans and MRI are done to detect acute
problems such as hematomas or edema (Polinder et al., 2018).
Diagnosis
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Injury
Hello Professor and class,
I will compare and contrast post concussive syndrome and traumatic brain injury.
Presentation (demographics, onset of symptoms, associated risk factors)
Post-Concussive Syndrome
Post-concussion syndrome is a term used to indicate a group of symptoms that occur after a
concussion (Bramley et al., 2016). Most individuals can recover from a concussion within 7-10
days, but those that do not recover within the usual time, they have PCS. This can happen to
anyone. Risk factors include previous concussions and preinjury mental health problems,
particularly depression (Iverson et al., 2017). PCS falls into one of four categories: vestibular
(imbalance, nausea, dizziness), sensory (blurry vision, migraines, tinnitus, photo/phonophobia),
cognitive (difficulty focusing, forgetfulness), and emotional (fatigue, insomnia, irritability,
depression) (Quin et al., 2018).
TBI
In 2014, there were about 2.87 million TBI-related ED visits, hospitalizations, and deaths that
occurred in the United States (Centers for Disease Control and Prevention, 2019). Sports and
recreational activities contribute to about 21 percent of all TBIs among American children and
adolescents. The American Congress of Rehabilitation Medicine defines traumatic brain injury
that results in the following, if present:
1) loss of consciousness for up to 30 minutes
2) alteration of consciousness for less than 24 hours
3) posttraumatic amnesia for less than 24 hours
4) a Glasgow Coma Scale score of 13–15 at 30 minutes after injury (Quinn
et al., 2018, pg. 104).
Signs and symptoms may appear within 24 hours or may emerge days or weeks after the injury
(Quinn et al., 2018). Risk factors for TBI are individuals 75 years of age and older, falls, and
motor vehicle accidents (CDC, 2019).
Pathophysiology
Post-Concussive Syndrome
The pathophysiology of post-concussion syndrome is a combination of metabolic, physiology,
and microstructural injuries to the brain. When head trauma produces a change in neurologic
function, neurochemical changes occur (Mullally, 2017). There is a release of excitatory
neurotransmitters, glutamate binding to N-7methyl-D-aspartate receptors in particular, which
causes a release of potassium into the extracellular space and then an influx of calcium going
into the cell. This creates a transient hypermetabolic glycolytic state – lactate is produced,
impairing neuronal function, and blood flow is reduced, and glucose utilization is diminished
(Mullally, 2017). Symptoms consistent with post-concussion syndrome result from autonomic
nervous system damage. This damage occurs to the white matter tracks between cortical control
centers and vagal nerve control via the spinal cord. Damage to the autonomic nervous system
also causes difficulties with control of cerebral blood flood, blood pressure and heart rate leading
to dizziness, headache, confusion, and difficulty with concentration (Mullally, 2017).
This study source was downloaded by 100000804717335 from CourseHero.com on 11-16-2025 08:52:36 GMT -06:00
https://www.coursehero.com/file/61041839/NR603-Week-1-Discussiondocx/
, TBI
TBI occurs when a traumatic event causes the brain to move rapidly within the skull, leading to
damage. The pathophysiology of TBI is a complex process that results from primary and
secondary injuries. Primary injury is directly caused by mechanical forces during the initial
insult. This occurs at the moment of trauma and includes contusion, damage to blood vessels,
and axonal shearing, where the axons of neurons are stretched and torn (Ng & Lee, 2019). The
blood brain barrier and meninges may be damaged, and neurons may die. Neuronal cell death
causes cerebral edema which raises intracranial pressure and causes brain damage (Pavlova et
al., 2018). The primary injury leads to secondary injury, which results from processes initiated by
the trauma. After the injury, the cerebral injury is illustrated by extreme tissue harm and
diminished metabolism and cerebral blood flow regulation (Pavlova et al., 2018). This produces
an ischemia-like condition, resulting in anaerobic glycolysis. Lactic acid accumulates and
membrane permeability increases, resulting in edema formation (Pavlova et al., 2018). Damage
to the blood brain results in the inactivation of free radial scavengers and the opening of ion
channels causing an influx of calcium. Two events occur – the first is cerebral edema occurs,
raising intracranial pressure and causing brain damage (Pavlova et al., 2018). The second is the
generation of free radicals, which impairs cerebral vasoregulation; therefore, reducing cerebral
blood flow, resulting in brain damage (Pavlova et al., 2018).
Assessment (physical assessment, diagnostic testing)
Post-Concussive Syndrome
Post-concussive syndrome is a sequela of a concussion. Symptoms of post-concussive syndrome
are headache, dizziness, vertigo, fatigue, memory problems, sleeping troubles, and trouble
concentrating (Polinder et al., 2018). A medical history should include history of previous TBIs,
head and neck injuries, and a detailed description of the number and extent of previous
concussions. A neurological exam should be completed, involving the orientation, speech,
concentration, memory, motor, sensory, and gait assessment (Polinder et al., 2018). Assessment
of depression, anxiety, stress, and mental health problems should be done. As for neuroimaging,
there is no consensus on whether imaging is necessary; however, some images of patients with
post-concussion symptoms have shown structural or functional abnormalitites (Polinder et al.,
2018)
TBI
An individual with TBI may present with vomiting, lethargy, headache, confusion, loss of
consciousness, vision changes, dizziness and balance problems, slow pulse, slow breathing rate,
speech difficulties, and loss of bladder or bowel control (Prince & Bruhns, 2017). A
neuropsychological evaluation is done to assess the cognitive and functional deficits results from
a neurological injury or disorder. A thorough exam is conducted to review the presenting
condition and associated symptoms. The Glasgow Coma Scale (GCS) is the most commonly
used assessment scale to grade the severity of the trauma (McKee & Daneshvar, 2015). It is
based on a 15-point scale: Score of 13-15 is mild, 9-12 is moderate disability, 3-8 is severe
disability, and less than 3 is vegetative state. CT scans and MRI are done to detect acute
problems such as hematomas or edema (Polinder et al., 2018).
Diagnosis
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