Head Neck Trauma

Head Neck Trauma - Head and Neck Trauma George C Phillips...

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Head and Neck Trauma George C. Phillips, MD, FAAP, CAQSM Clinical Assistant Professor of Pediatrics September 20, 2007
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Case History 16-year-old male football player Helmet-to-helmet collision during practice six days prior to initial visit in our center Confused and disoriented at the time of injury Bilateral upper extremity numbness and tingling that lasted 20 minutes
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Case History Evaluated on the day of injury at a local emergency department Head CT showed right frontal soft tissue swelling, with normal brain parenchyma Diagnosed with concussion and removed from participation until follow-up at the University of Iowa Sports Medicine Center
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Case History At our initial visit, he reported retrograde and post-traumatic amnesia He denied headache, dizziness, blurry vision, confusion, tinnitus, or cognitive/school performance issues He went running the previous day without symptoms
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Case History Patient reports a previously unrecognized injury occurring one week prior to the index injury Helmet-to-helmet contact Bilateral upper extremity numbness/tingling Brief loss of vision in left eye Symptoms resolved within 24 hours
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Case History No prior head trauma Multiple hand fractures No surgeries Exercise-induced asthma, well-controlled
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Physical Examination HEENT, Neck, Pulmonary, Cardiovascular, Abdominal, and Skin exams were unremarkable No C-spine tenderness Negative Spurling’s maneuver No visual or ocular disturbances Negative Battle sign
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Physical Examination Impaired delayed recall (3/5 words) Mild concentration difficulties (6 digits, reverse order of months) Balance impairment (single leg stand with eyes closed) Fully oriented, immediate memory intact Intact light touch and 2-point discrimination
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Head Neck Trauma - Head and Neck Trauma George C Phillips...

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