CCSP Concussion Evaluation and Management 2 — Questions and Answers
Question 1: Which grading scale for concussion severity was officially retired by major sports medicine organizations in favor of individualized assessment?
- Cantu Grading System (Correct answer)
- SCAT5 Scale
- Glasgow Coma Scale
- King-Devick Test
Correct answer: Cantu Grading System
The Cantu and other traditional grading systems were retired because concussion severity cannot be accurately determined at sideline and must be assessed individually over time.
Question 2: A 16-year-old soccer player reports visual disturbances and photophobia after a head impact. Which cranial nerve is most likely implicated in the photophobia symptom?
- Cranial Nerve III (Oculomotor) (Correct answer)
- Cranial Nerve II (Optic)
- Cranial Nerve IV (Trochlear)
- Cranial Nerve VII (Facial)
Correct answer: Cranial Nerve III (Oculomotor)
Photophobia after concussion is primarily mediated by cranial nerve III (oculomotor), which controls the pupillary light reflex and is sensitive to light stimulation.
Question 3: In the context of concussion management, what does 'cognitive rest' primarily involve?
- Complete bed rest for 24-48 hours
- Limiting mentally demanding activities that worsen symptoms (Correct answer)
- Avoiding all social interactions
- Stopping all physical activity indefinitely
Correct answer: Limiting mentally demanding activities that worsen symptoms
Cognitive rest involves limiting activities such as reading, screen time, and mentally demanding tasks that exacerbate concussion symptoms, not necessarily complete isolation.
Question 4: Which neurotransmitter is primarily implicated in the ionic cascade following concussive injury, leading to the metabolic crisis?
- Dopamine
- Serotonin
- Glutamate (Correct answer)
- GABA
Correct answer: Glutamate
Glutamate is massively released following concussive injury, activating NMDA receptors and triggering an ionic cascade that leads to the neurometabolic crisis.
Question 5: A high school football player is cleared for return to play after concussion. During what stage of the graduated return-to-sport protocol can he first participate in non-contact training drills?
- Stage 2
- Stage 3
- Stage 4 (Correct answer)
- Stage 5
Correct answer: Stage 4
Stage 4 (sport-specific exercise) of the graduated return-to-sport protocol is when non-contact training drills are introduced after aerobic and sport-specific activities.
Question 6: Which baseline testing tool assesses neurocognitive function, balance, and symptom reporting as part of a comprehensive concussion evaluation battery?
- Standardized Assessment of Concussion (SAC)
- ImPACT test
- SCAT5 (Correct answer)
- Maddocks Questions
Correct answer: SCAT5
The SCAT5 (Sport Concussion Assessment Tool 5) is the most comprehensive sideline tool combining symptom evaluation, cognitive screening (SAC), and balance assessment (BESS).
Question 7: Post-concussion syndrome is generally defined by symptom persistence beyond what timeframe in adults?
- 7 days
- 10 days
- 4 weeks (Correct answer)
- 3 months
Correct answer: 4 weeks
Post-concussion syndrome is generally defined as persistent symptoms lasting more than 4 weeks in adults, though some definitions extend this to 3 months.
CCSP Concussion Evaluation and Management 2
Which grading scale for concussion severity was officially retired by major sports medicine organizations in favor of individualized assessment?