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Hemorrhagic Stroke - Harvard Health
Netflix poster of My Beautiful Broken Brain. If any of these occur after a blow to the head, a health-care professional should be consulted as soon as possible. The skull protects the brain against penetrating trauma, but does not absorb all the impact of a violent force. The brain is cushioned inside the skull by the surrounding cerebrospinal fluid.
Despite this, an abrupt blow to the head, or even a rapid deceleration, can cause the brain to contact the inner side of the skull. There is a potential for tearing of blood vessels, pulling of nerve fibers and bruising of the brain substance.
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Sometimes the blow can result in microscopic damage to the brain cells without obvious structural damage visible on a CT scan. In severe cases, the brain tissue can begin to swell. Since the brain cannot escape the rigid confines of the skull, severe swelling can compress the brain and its blood vessels, limiting the flow of blood. Without adequate blood flow, the brain does not receive the necessary flow of oxygen and glucose.
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A stroke can occur. Brain swelling after a concussion has the potential to amplify the severity of the injury. A blow to the head can cause a more serious initial injury to the brain. A contusion is a bruise of the brain tissue involving bleeding and swelling in the brain. A skull fracture occurs when the bone of the skull breaks. A skull fracture by itself may not necessarily be a serious injury.
Sometimes, however, the broken skull bones cause bleeding or other damage by cutting into the brain or its coverings. A hematoma is a blood clot that collects in or around the brain. If active bleeding persists, hematomas can rapidly enlarge. Like brain swelling, the increasing pressure within the rigid confines of the skull due to an enlarging blood clot can cause serious neurological problems, and can even be life-threatening.
Some hematomas are surgical emergencies. Hematomas that are small can sometimes go undetected initially, but may cause symptoms and require treatment several days or weeks later.
It Started as a Headache...
After a player is diagnosed with a concussion, the protocol calls for a minimum of daily monitoring. The protocol progresses through a series of steps, moving to the next step only when all activities in the current step are tolerated without recurrence of symptoms. Communication between the player and the medical staff during the protocol is essential.
The first step is rest. During this time, in additional to avoiding physical exertion, the player is to avoid electronics, social media and even team meetings until his returns to his baseline level of signs and symptoms. If aerobics are tolerated, the team physician will reintroduce strength training. The fourth step includes some non-contact football-specific activities, and the fifth step, which is clearance to resume full football activity, comes only after neurocognitive testing remains at baseline and there are no recurrence of signs of symptoms of a concussion.
When the team physician gives the player final clearance, the player has a final examination by the INC assigned to his team. Once the INC confirms the conclusion of the team physician, the player is considered cleared and is eligible for full participation in the next game or practice.
This protocol allows for players to heal at their own individual rates, includes the expertise of both the team physicians and a neurological consultant and specifically includes an assessment of not only the most recent concussion but also takes into account the medical history of the player. The handbook also states, "NCAA member institutions must have a concussion management plan for their student-athletes on file with specific components as described in Bylaw 3.
The signs of a concussion, according to the NCAA , are as follows:. The NCAA handbook includes much more information on concussions starting on page The standard treatment for concussion is rest. For headaches, acetaminophen Tylenol can be taken.
Postconcussive headaches often are resistant to stronger narcotic-based medications. People who suffer a head injury may suffer from side effects that persist for weeks or months. This is known as post-concussive syndrome. Symptoms include memory and concentration problems, mood swings, personality changes, headache, fatigue, dizziness, insomnia and excessive drowsiness.
Patients with post-concussive syndrome should avoid activities that put them at risk for a repeated concussion. Athletes should not return to play while experiencing these symptoms.
Athletes who suffer repeated concussions should consider ending participation in the sport. Second-impact syndrome results from acute, often fatal brain swelling that occurs when a second concussion is sustained before complete recovery from a previous concussion. This is thought to cause vascular congestion and increased intracranial pressure, which can occur very rapidly and may be difficult or impossible to control. The risk of second-impact syndrome is higher in sports such as boxing, football, ice or roller hockey, soccer, baseball, basketball and snow skiing. The CDC reports an average of 1.
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