Pathophysiologyof Concussive Injuries and Treatment
Concussionis a biochemically instigated brain injury often typified by lack ofgross anatomic lesions (Tsao, 2012). Rapid deceleration in the skullimparts shearing forces on the brain that causes mechanical andmetabolic changes. Mechanical changes are often diffuse. Long axonsusually involved in high level functions are highly vulnerable.Concussion effects are often less diffuse leading to cognitivesequelae like concentration problems and memory difficulties. Thestretching of the axons leads to a cascade of biochemical changescharacterized by depolarization and release of excitatoryneurohormones which result in influx of potassium and calcium ionsacross the vascular and neural tissues leading to a hyper glycolyticstate as an attempt is made to restore the equilibrium state (Tsao,2012). The influx of calcium leads to vasoconstriction of bloodvessels in the brain thus reducing glucose delivery and blood flow tothe brain cells. This state leads to metabolic depression due to lackof adequate energy. This cascade of events increases thesusceptibility of the neural tissue to further injury.
NeurologicalAssessment Tools Used
Neurologicalexamination evaluates the sensory and motor responses. Assessment ofreflexes is done to determine the level of impairment of the nervoussystem. The instruments used include reflex hammers and lights. Forconsciousness assessment, clinicians use the Glasgow Coma Scale. Itis a scoring system that outlines the consciousness level of a personafter an injury affecting the brain (Jarvis, 2016). GCS gauges theseverity of the trauma to the brain. GCS measures the eye, motor, andverbal responses. Doctors use the GCS to rate the best response. Thisscale classifies brain injury into severe, moderate, and milddepending on the score (Jarvis, 2016).
Currently,there exist many good treatment options for PTSD. They include:
CBThelps patients to understand and change their thinking abouttraumatic events and their aftermath. The main aim is to make thepatient comprehend how certain thoughts about traumatic events leadto stress and worsening of the disease (Tsao, 2012). With the help ofthe counselor, one learns how to replace these thoughts with lessstressing thoughts.
Otherbest practices include use of medications such as citalopram, use ofEye Movement Desensitization and Reprocessing Therapy, ExposureTherapy, and Group Therapy (Tsao, 2012).
Evaluatethe patient’s behavior and ensure the patient remains safe.Encourage the patient to identify any triggers, reorient the patientwhen necessary, use de-escalation techniques and ensure the patienttakes medication as prescribed (Tsao, 2012).
Jarvis,C. (2016). Physicalexamination &amp health assessment(7th ed.). St. Louis, MO: Saunders Elsevier.
Tsao,J. W. (2012). Traumaticbrain injury: a clinician`s guide to diagnosis, management, andrehabilitation.New York: Springer.