Concussion

Definitions

Traumatic Brain Injury: A traumatic brain injury (TBI) involves a disruption of normal brain function as a result of exposure to an external physical force. The trauma may involve a direct impact from an object striking the head or the head striking an object. Damage to the brain can be indirect, as when the rest of the body is suddenly subjected to acceleration or deceleration or to the shock wave from an intense explosion. TBIs may have mild to profound effects on physical, psychological, emotional, and/or social functioning. They are classified in multiple ways. A primary injury refers to damage that immediately results from the trauma, and may involve bruises and bleeding in the brain itself or damage to surrounding structures. This primary event can set in motion a series of molecular responses that can lead to further damage, through changes in membrane activity, release of neurotransmitters, oxygen deprivation, swelling, increased pressure inside the skull, etc.TBIs can also be further classified by type (open vs. closed; uncomplicated vs. complicated) and severity.

Closed Traumatic Brain Injury: A closed traumatic brain injury occurs when the skull is not fractured or penetrated, but brain tissue is damaged by the forces that cause shifting or stretching and contact between the brain and the rough inside surface of the skull.

Open Traumatic Brain Injury: An open traumatic brain injury occurs when the skull has been fractured or penetrated by a foreign object. Open head injuries expose the brain to the outside world and bring an increased risk of complications such as infection, leakage and disrupted flow of cerebrospinal fluid, and seizures.

Concussion: Concussion is a clinical subset accounting for an estimated 75 to 90 percent of traumatic brain injuries. In the United States, the term is often used interchangeably with Mild Traumatic Brain Injury (mTBI). Six key elements characterize concussion: (1) it is a complex pathophysiological process; (2) it results in the rapid onset of neurological impairment that typically resolves spontaneously; (3) loss of consciousness and amnesia may or may not occur; (4) brain imaging (e.g., CT scan, MRI) typically fails to show evidence of structural abnormality, and brain dysfunction in concussion is usually related to problems with brain metabolism rather than structural damage or injury; (5) multiple domains are often affected in its aftermath (i.e., physical, behavioral, cognitive, and sleep disturbances); and (6) clinical presentation varies substantially across individuals.

Post-Concussive Syndrome (PCS): Post-concussive or post-concussion syndrome is a set of symptoms that may continue for weeks, months, or occasionally a year or more after a concussion. Common features include headache, dizziness, irritability, diminished concentration, sleep disturbance, and intolerance to stimulation (e.g., lights or sound).

Cumulative Head Trauma: The damage caused by repeated blows to the head or multiple concussions. Evidence is accumulating for a new clinical entity known as Cumulative Traumatic Encephalopathy (CTE), which is characterized by a progressive deterioration of functioning heralded by mood and personality changes and ultimately resulting in global dementia. Professional athletes in football, hockey, and boxing appear to be at elevated risk for this syndrome.

Blast Trauma: A new category of brain injury that occurs when the human body is subjected to intense pressure emanating from explosions. This injury has been seen extensively in military service members returning from the Middle East who have been exposed to blasts from improvised explosive devices and rocket-propelled grenades.

Second Impact Syndrome: A dire clinical situation in which an individual with an unresolved TBI undergoes a second — sometimes seemingly minor — brain injury hours or days later, and then suffers life-threatening or fatal complications. It is thought that the underlying molecular alterations that are set in motion following the initial injury render the brain exceedingly vulnerable to further damage for a narrow window of time. Preventing this syndrome is one of the main objectives of the “return to play” restrictions following TBI.Source: https://www.ets.org/s/disabilities/pdf/documenting_traumatic_brain_injury.pdf

Concussion Policy

  • Students who have incurred a concussion should first contact their professors and provide them with documentation regarding their injury so that they can discuss their situation and immediate concerns.
  • Students who are experiencing post-concussive symptoms beyond 5 to 10 days should seek assistance from SSD. The symptoms may include but are not limited to headache, dizziness, irritability, diminished concentration, sleep disturbance, and intolerance to stimulation such as lights and sounds. SSD has assistive technology that can support students in alleviating post-concussive symptoms associated with extended periods of mental exertion.
  • Students requiring academic accommodations based on symptomatology will be authorized for accommodations on a temporary basis for one semester. For students whose symptoms continue beyond one semester please refer to our cognitive disability documentation guidelines. - Faculty/staff - Other Resources
  • It is the obligation of the student to reach out to SSD if their symptoms continue beyond one semester or there is a change in their symptoms during the semester.